Active NPI
Brian A Jackson, CADC I
- Addiction (Substance Use Disorder) Counselor
- Medford, OR
National Provider Identifier
1841651007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 1025 E Main St
Medford, OR 97504 - Phone
- (541) 779-1282
- Fax
- (541) 608-2888
- NPI assigned
- Mar 16, 2016
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
1025 E Main St
Medford, OR 97504
Mailing address
1003 E Main St Ste 104
Medford, OR 97504-7140
Phone (541) 779-1282
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Addictions Recovery Center, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Substance Abuse Rehabilitation Facility
- Medford, OR
- NPI 1346282035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534982400000",
"number": "1841651007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1003 E MAIN ST STE 104",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975047140",
"telephone_number": "541-779-1282",
"fax_number": "541-608-2888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 E MAIN ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "97504",
"telephone_number": "541-779-1282",
"fax_number": "541-608-2888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "BRIAN",
"middle_name": "A",
"credential": "CADC I",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-16",
"last_updated": "2018-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.