Jackson Medical Solutions, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

JACKSON MEDICAL SOLUTIONS, INC.

Practice address

5613 W Western Star Blvd
Laveen, AZ 85339-1217

Phone

(520) 595-8145

NPI assigned

Jul 29, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Ian Jackson, BSBME

Title

President/Ceo

Phone

(520) 595-8145

Specialties & licenses 1

Addresses

Other names 4

• JMS Doing business as
• Jackson Med Doing business as
• Jackson Medical Doing business as
• Jackson Medical Solutions Doing business as

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1679209704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5613 W WESTERN STAR BLVD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853391217",
            "telephone_number": "520-595-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5613 W WESTERN STAR BLVD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853391217",
            "telephone_number": "520-595-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MEDICAL SOLUTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "520-595-8145",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSBME"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jackson Med",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jackson Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jackson Medical Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Laveen, AZ
• Providers in Laveen, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.