Jackley Chiropractic Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2004021819 Issued in MO

Legal business name

JACKLEY CHIROPRACTIC INC.

Practice address

15807 E 23Rd St S
Independence, MO 64055-1908

Phone

(816) 254-3203

Fax

(816) 252-0012

NPI assigned

Sep 20, 2007

Last updated

Jul 10, 2013By 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

Chad JackleyNPI 1770653420

Title

President

Phone

(816) 254-3203

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chad Jackley, D.C.

  • Chiropractor
  • Independence, MO
  • NPI 1770653420
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373414400000",
    "number": "1639365968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15807 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640551908",
            "telephone_number": "816-254-3203",
            "fax_number": "816-252-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15807 E 23RD ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640551908",
            "telephone_number": "816-254-3203",
            "fax_number": "816-252-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKLEY CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2013-07-10",
        "status": "A",
        "authorized_official_last_name": "JACKLEY",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-254-3203"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2004021819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivna Medical Group LLC (Stadium Pharmacy)
• Annie Jack
• Sara Jackaway, MA PLPC
• David Shawn Jackel, APRN, FNP-BC
• Jackie Ransom, LPC, LLC
• Chad Jackley, D.C.
• Jackson County Medical Group LLC
• Jackson County Pulmonary Medical Group LLC
• Jackson County Pulmonary PC
• Jackson Drive Emergency Physicians LLC

• Chiropractor in Independence, MO
• Providers in Independence, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.