James Jackson D.O., P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

JJ004758 Issued in MI

Legal business name

JAMES JACKSON D.O., P.C.

Practice address

2416 Peck Street
James Jackson D.O., P.C.
Muskegon HTS., MI 49444

Phone

(231) 739-5574

Fax

(231) 739-5574

NPI assigned

Jul 7, 2010

Last updated

Oct 8, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. James Jackson Sr., DO

Title

Owner

Phone

23173955574

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1619289642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 PECK STREET",
            "address_2": "JAMES JACKSON D.O., P.C.",
            "city": "MUSKEGON HTS.",
            "state": "MI",
            "postal_code": "49444",
            "telephone_number": "231-739-5574",
            "fax_number": "231-739-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 PECK STREET",
            "address_2": "JAMES JACKSON D.O., P.C.",
            "city": "MUSKEGON HTS.",
            "state": "MI",
            "postal_code": "49444",
            "telephone_number": "231-739-5574",
            "fax_number": "231-739-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES JACKSON D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-07",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "23173955574",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "JJ004758",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101004758",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006466",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Muskegon HTS, MI by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.