Individual provider Active NPI

Paul Dermot Jackman, D.C.

  • Chiropractor
  • Framingham, MA
National Provider Identifier
1801057369
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3158 Issued in MA
Practice address
657 Franklin St
Framingham, MA 01702-2960
Phone
(508) 879-9458
Fax
(508) 879-4053
NPI assigned
Jun 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3158 MA Primary

Addresses

Primary practice location

657 Franklin St
Framingham, MA 01702-2960

Mailing address

657 Franklin St
Framingham, MA 01702-2960
Phone (508) 879-9458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110405000144 MA Practitioner - Chiropractic 5193909810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

657 Franklin St
Framingham, MA 01702-2960
Phone (508) 879-9458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3158MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Framingham Chiropractor Inc Chiropractor CurrentSince Oct 18, 2021 Accepting new patients
Richard N Garian D.C. LLC CurrentSince Nov 9, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

657 Franklin St
Framingham, MA 01702
Phone (508) 872-3284

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1801057369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 FRANKLIN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017022960",
            "telephone_number": "508-879-9458",
            "fax_number": "508-879-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 FRANKLIN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017022960",
            "telephone_number": "508-879-9458",
            "fax_number": "508-879-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKMAN",
        "first_name": "PAUL",
        "middle_name": "DERMOT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.