Adam Jacks, PH.D.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8495 Issued in NC

Practice address

6015 Farrington Rd
Suite 103
Chapel Hill, NC 27517-8154

Phone

(919) 966-5975

Fax

(919) 966-8384

NPI assigned

Aug 7, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Interoperability endpoints

• Direct secure messaging: ajacks169981@direct.unc.nchie.net

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1881825883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 FARRINGTON RD",
            "address_2": "SUITE 103",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275178154",
            "telephone_number": "919-966-5975",
            "fax_number": "919-966-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 FARRINGTON RD",
            "address_2": "SUITE 103",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275178154",
            "telephone_number": "919-966-5975",
            "fax_number": "919-966-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKS",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-07",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "8495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajacks169981@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "6015 Farrington Rd",
            "address_2": "Suite 103",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275178154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Speech-Language Pathologist in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.