# JACKSON MEDICAL ENTERPRISES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093640989
- **Authorized official:** DR. DENNIS NATHANIEL JACKSON M.D. (OWNER)
- **Authorized official phone:** (313) 461-6194

## Contact information

- **Practice address:** 8905 W POST RD STE 110, LAS VEGAS, NV 89148-2429
- **Practice address phone:** (313) 461-6194
- **Mailing address:** 5055 S FORT APACHE RD UNIT 280, LAS VEGAS, NV 89148-1558
- **Mailing address phone:** (313) 461-6194

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PS0010X | Sports Medicine (Emergency Medicine) Physician | — | NULL | Yes |
| 207PS0010X | Sports Medicine (Emergency Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/15/2026
- **Last updated:** 06/15/2026