Active NPI
Jessica Ann Yackley, DC
- Chiropractor
- Raleigh, NC
National Provider Identifier
1639815921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5602
- Practice address
- 4418 Crystal Breeze St
Raleigh, NC 27614-8682 - Phone
- (563) 940-0981
- NPI assigned
- May 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHR.0008534 | CO | |
| Chiropractor | 111N00000X | 5602 | NC | Primary |
Addresses
Primary practice location
4418 Crystal Breeze St
Raleigh, NC 27614-8682
Mailing address
4418 Crystal Breeze St
Raleigh, NC 27614-8682
Phone (563) 940-0981
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 |
|---|---|---|---|
| CHR.0008534 | CO | MD | Chiropractor |
| 5602 | NC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1639815921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4418 CRYSTAL BREEZE ST",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276148682",
"telephone_number": "563-940-0981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4418 CRYSTAL BREEZE ST",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276148682",
"telephone_number": "563-940-0981"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YACKLEY",
"first_name": "JESSICA",
"middle_name": "ANN",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-09",
"last_updated": "2023-07-10",
"certification_date": "2023-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "CHR.0008534",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "5602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.