Individual provider Active NPI

Jeremy Michael Jackson

  • Clinical Exercise Physiologist
  • San Antonio, TX
National Provider Identifier
1659277564
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Exercise PhysiologistTaxonomy code 224Y00000X
Practice address
8811 Village Dr Ste 160
San Antonio, TX 78217-5415
Phone
(210) 297-2270
Fax
(210) 297-2275
NPI assigned
Oct 16, 2026
Last updated
Oct 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Exercise Physiologist 224Y00000X NU Primary

Addresses

Primary practice location

8811 Village Dr Ste 160
San Antonio, TX 78217-5415

Mailing address

8811 Village Dr Ste 160
San Antonio, TX 78217-5415
Phone (210) 297-2270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1792108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1659277564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8811 VILLAGE DR STE 160",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175415",
            "telephone_number": "210-297-2270",
            "fax_number": "210-297-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8811 VILLAGE DR STE 160",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175415",
            "telephone_number": "210-297-2270",
            "fax_number": "210-297-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JEREMY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-16",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.