Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
JACKSON CHIROPRACTIC INC
Active
Organization
JACKSON CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARRELL KEITHE JACKSON D.C. (PRESIDENT)
(530) 621-4803
Entity
Organization
Contact information
Practice address
3330 CAMERON PARK DR STE 200, CAMERON PARK, CA 95682-7652
(530) 621-4803
(530) 621-2450
Mailing address
3330 CAMERON PARK DR STE 200, CAMERON PARK, CA 95682-7652
(530) 621-4803
(530) 621-2450
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
20634
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DCO206340
BLUE SHIELD PROVIDER #
CA
01
—
ZZZ61178Z
BLUE SHIELD
CA
Enumeration date
11/15/2006
Last updated
05/13/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up