Jackson Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2012014933 Issued in MO

Legal business name

JACKSON CHIROPRACTIC

Practice address

1258 Bryan Rd
O Fallon, MO 63366-3771

Phone

(636) 614-0401

Fax

(636) 614-4111

NPI assigned

Aug 2, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Garrett Rodney Jackson, D.C.

Title

Sole Member

Phone

(636) 614-0401

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brandon T. Jackson, D.C.

  • Chiropractor
  • O Fallon, MO
  • NPI 1578896031
  NPD (past)

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348185600000",
    "number": "1669728101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 BRYAN RD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663771",
            "telephone_number": "636-614-0401",
            "fax_number": "636-614-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 BRYAN RD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663771",
            "telephone_number": "636-614-0401",
            "fax_number": "636-614-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-02",
        "last_updated": "2012-09-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_middle_name": "RODNEY",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "636-614-0401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2012014933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marium Iqbal
• Iverson-Tomasino Eyecare Inc
• Christina Marie Ivy, FNP-C
• Daniel Jablonski, D.C.
• Jack W. Haney, D.D.S., P.C.
• Bradley C Jackson
• Brandon T. Jackson, D.C.
• Garrett Rodney Jackson, D.C.
• Sarah Marie Jackson, DO
• Heidi Kathleen Jacobs, FNP

• Chiropractor in O Fallon, MO
• Providers in O Fallon, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.