Bryan W Jackson, D.C., P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

005803 Issued in CT

Practice address

410 Saybrook Rd Ste 100
Middletown, CT 06457

Phone

(860) 638-3820

Fax

(860) 638-3840

NPI assigned

Aug 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedic and Neurosurgery Specialists, PLLCGroup PAC ID 5294628947, 255 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.22 of 100Reported as group

Quality

82.55

Promoting interoperability

100

Improvement activities

40

Cost

64.86

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Orthopaedic & Neurosurgery Specialists, PLLC

  • Orthopaedic Surgery Physician
  • Greenwich, CT
  • NPI 1033318720

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Middlesex Orthopedic Surgeons PC

  • Orthopaedic Surgery Physician
  • Middletown, CT
  • NPI 1558474742
  NPD
• Orthopaedic & Neurosurgery Specialists, PLLC

  • Orthopaedic Surgery Physician
  • Newington, CT
  • NPI 1043086531
  NPD

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1649288317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK RD STE 100",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574780",
            "telephone_number": "860-638-3820",
            "fax_number": "860-638-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK RD STE 100",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "06457",
            "telephone_number": "860-638-3820",
            "fax_number": "860-638-3840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5215 South Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282172771",
            "country_code": "US",
            "telephone_number": "704-525-6288",
            "fax_number": "704-525-6384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRYAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.C., P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3372",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "9924",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "005803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rizwan Iqbal, M.D.
• Francisco Irby, MD
• Sally J Irons, MD
• It Is Well Integrative Partners
• Mary Suzanne Izzo, RD
• Lakshit Jain, M.B.B.S.
• Ravi Jain, MD
• Robert Jakubiec, DDS
• Courtney James, LCSW
• Mary E Jamesr, RN

• Physical Therapist in Middletown, CT
• Providers in Middletown, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.