Active NPI
Christopher Bryan Jackson
- Student in an Organized Health Care Education/Training Program
- Austin, TX
National Provider Identifier
1689179608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 35449
- Practice address
- 110 Inner Campus Dr
College of Pharmacy
Austin, TX 78712 - Phone
- (512) 471-1737
- NPI assigned
- Mar 30, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 35449 | TX | Primary |
Addresses
Primary practice location
110 Inner Campus Dr
College of Pharmacy
Austin, TX 78712
Mailing address
4616 Triangle Ave Apt 4110
Austin, TX 78751-3501
Phone (512) 318-6471
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 |
|---|---|---|---|
| 35449 | TX | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522368000000",
"number": "1689179608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4616 TRIANGLE AVE APT 4110",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787513501",
"telephone_number": "512-318-6471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 INNER CAMPUS DR",
"address_2": "COLLEGE OF PHARMACY",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78712",
"telephone_number": "512-471-1737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CHRISTOPHER",
"middle_name": "BRYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-30",
"last_updated": "2018-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TX",
"license": "35449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.