Dean C Jacks, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH0007168 Issued in FL

Practice address

1550 John Sims Pkwy E
Niceville, FL 32578-2138

Phone

(850) 678-8048

Fax

(855) 333-8662

NPI assigned

Jul 19, 2006

Last updated

Oct 16, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Core Chiropractic Center Inc

  • Chiropractor
  • Niceville, FL
  • NPI 1639566797
  Medicare reassignment NPD Authorized official
• Emerald Coast Chiropractic Inc

  • Chiropractor
  • Niceville, FL
  • NPI 1871519165
  Authorized official Same address or phone
• Ewing Family Chiropractic

  dba Russell Chiropractic

  • Chiropractor
  • Niceville, FL
  • NPI 1962876623
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1619996493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 JOHN SIMS PKWY E",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782138",
            "telephone_number": "850-678-8048",
            "fax_number": "855-333-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 JOHN SIMS PKWY E",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782138",
            "telephone_number": "850-678-8048",
            "fax_number": "855-333-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKS",
        "first_name": "DEAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350046350",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "55486",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzan Hughes, APRN
• Hygeia Medical Group PA
• Jessica L Iacovetta
• In Your Dreams International Inc (Emerald Coast Sleep Disorders Center)
• Integrated Regional Laboratories Pathology Services, LLC
• Jacksonville Emergency Consultants
• James D. Hemmig, O.D., P.a.
• Christine Jean, PSY.D.
• Sarah Jensen
• Amy Fetters Jimenez, IBCLC

• Chiropractor in Niceville, FL
• Providers in Niceville, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.