Active NPI
Cara Jacskon, DC
- Chiropractor
- College Park, GA
National Provider Identifier
1568029288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIR006970
- Practice address
- 1720 Phoenix Blvd Ste 300
College Park, GA 30349-5595 - Phone
- (678) 358-5602
- NPI assigned
- May 29, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIR006970 | GA | Primary |
Addresses
Primary practice location
1720 Phoenix Blvd Ste 300
College Park, GA 30349-5595
Mailing address
629 Champions Dr
McDonough, GA 30253-4284
Phone (678) 358-5602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIR006970 | GA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559088000000",
"number": "1568029288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "629 CHAMPIONS DR",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302534284",
"telephone_number": "678-358-5602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 PHOENIX BLVD STE 300",
"city": "COLLEGE PARK",
"state": "GA",
"postal_code": "303495595",
"telephone_number": "678-358-5602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACSKON",
"first_name": "CARA",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-29",
"last_updated": "2019-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR006970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.