Christian Tyler Jackson

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5092 Issued in NC

Practice address

120 Unionville Indian Trail Rd W Ste C102
Indian Trail, NC 28079-5670

Phone

(704) 821-5000

NPI assigned

Mar 20, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

Sherman College of Straight Chiropractic, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apex Chiropractic and Wellness, PLLCGroup PAC ID 9032548326, 2 clinicians

Practice addresses (Care Compare)

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.

• Apex Chiropractic and Wellness, PLLC

  • Chiropractor
  • Indian Trail, NC
  • NPI 1952937252
  Medicare reassignment Care Compare group NPD Authorized official
• Kaisk Chiropractic

  • Chiropractor
  • Indian Trail, NC
  • NPI 1588209977
  NPD

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

{
    "created_epoch": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1720614837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 UNIONVILLE INDIAN TRAIL RD W STE C102",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795670",
            "telephone_number": "704-821-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 UNIONVILLE INDIAN TRAIL RD W STE C102",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795670",
            "telephone_number": "704-821-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTIAN",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-20",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Indian Trail Pharmacy, Inc.
• Indian Trail Specific Chiropractic Inc
• Infinity Dental Arts
• Innercity Transportation LLC
• Integrative Chiropractic and Natural Medicine
• Desha Perry Jacobs, RN, CDE
• Tracey L. Jaglal, MS, CCC-SLP
• Jaki Med Inc
• James F. Matthews OD PA
• Nancy Viola James, A-GNP

• Chiropractor in Indian Trail, NC
• Providers in Indian Trail, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; 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.