Active NPI
Jackson Emprise L.L.C.
- Chiropractor
- Phoenix, AZ
National Provider Identifier
1841903804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Legal business name
- JACKSON EMPRISE L.L.C.
- Practice address
- 15620 N Tatum Blvd Ste 130
Phoenix, AZ 85032-4450 - Phone
- (602) 612-2009
- Fax
- (602) 916-0834
- NPI assigned
- Jan 4, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jordan Jackson, D.C.
- Title
- Clinic Owner
- Phone
- (602) 612-2009
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | Primary |
Addresses
Primary practice location
15620 N Tatum Blvd Ste 130
Phoenix, AZ 85032-4450
Mailing address
15620 N Tatum Blvd Ste 130
Phoenix, AZ 85032-4450
Phone (602) 612-2009
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | drjordan@100percentdoc.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
15620 N Tatum Blvd
#130
Phoenix, AZ 85032
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Las Vegas, NV
- NPI 1689322299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672790400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1672790400000",
"number": "1841903804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15620 N TATUM BLVD STE 130",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850324450",
"telephone_number": "602-612-2009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15620 N TATUM BLVD STE 130",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850324450",
"telephone_number": "602-612-2009",
"fax_number": "602-916-0834"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JACKSON EMPRISE L.L.C.",
"organizational_subpart": "NO",
"enumeration_date": "2023-01-04",
"last_updated": "2023-01-04",
"certification_date": "2023-01-04",
"status": "A",
"authorized_official_last_name": "JACKSON",
"authorized_official_first_name": "JORDAN",
"authorized_official_title_or_position": "CLINIC OWNER",
"authorized_official_telephone_number": "602-612-2009",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "drjordan@100percentdoc.com",
"affiliation": "N",
"address_1": "15620 N Tatum Blvd Ste 130",
"city": "Phoenix",
"state": "AZ",
"country_code": "US",
"postal_code": "850324450",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.