Richard Allen Jackson, HS

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

Kaehler Memorial Medical Clinic
US Coast Guard
Otis Angb, MA 02542

Phone

(508) 968-6713

NPI assigned

Dec 14, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

High School Graduate

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coast Guard

  • Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
  • Washington, DC
  • NPI 1528142809
  Authorized official Same address or phone

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1952386690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5690 PEETS ST",
            "city": "OTIS ANGB",
            "state": "MA",
            "postal_code": "025421030",
            "telephone_number": "503-504-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KAEHLER MEMORIAL MEDICAL CLINIC",
            "address_2": "US COAST GUARD",
            "city": "OTIS ANGB",
            "state": "MA",
            "postal_code": "02542",
            "telephone_number": "508-968-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RICHARD",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "HS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "B0415118",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.