Kelly A Jackson, DC
Chiropractor in Natick, MA. Individual provider (NPI-1).
NPI number1104986793
StatusActive
Last updated in NPPESOct 20, 2021
Details
- NPI
- 1104986793
- Entity type
- Individual (NPI-1)
- Name
- Kelly A Jackson
- Credential
- DC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 12, 2006
- Certification date
- Oct 20, 2021
- Last updated
- Oct 20, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CHIROPRACTIC
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 1797 | MA | Yes |
Practice location
190 North Main StreetNatick, MA 01760
Phone 508-651-2646 · Fax 508-655-6650
Mailing address
190 North Main StreetNatick, MA 01760
Phone 508-651-2646 · Fax 508-655-6650
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