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Deactivated NPI 1376249516 Deactivated / Inactive NPI Male Practitioner

Dr. Jackson Dale Clements , DC

Chiropractor • Overland Park, KS

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jackson Clements has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 31, 2023
NPI Deactivation Date February 03, 2023
Total Practice Duration ~1 Years of Practice (2023 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Jackson Clements, DC was a registered Chiropractor practicing in Overland Park, KS. Throughout an active medical career spanning 1 years, Dr. Clements provided care at the practice location at 12631 ANTIOCH RD until profile deactivation on 2023-02-03.

Practice Location & Contact Primary Location

Practice Address

12631 Antioch Rd

Overland Park, KS 662131701

Telephone 9136850022
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Overland Park, KS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.8 Yrs
State Avg: 20.7 Yrs
Regional Practice Density
234 Specialists

Practicing in Overland Park, KS (1507 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-02-11
Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License KS 01-06246

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1447348289

Doctor of Chiropractic, Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Reactivated February 11, 2023

Record officially reactivated for active practice on February 11, 2023

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Updated Practice Location February 11, 2023

Registered at 12631 ANTIOCH RD, OVERLAND PARK, KS 662131701 (Tel: 9136850022)

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Updated Business Mailing Address February 11, 2023

Registered at 14751 OUTLOOK ST, OVERLAND PARK, KS 662231182 (Tel: 9135686287)

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Provider Name / Credentials Updated February 11, 2023

Recorded as JACKSON CLEMENTS, DC

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 11, 2023

Chiropractor (License #01-06246 in KS)

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NPI Profile Deactivated February 03, 2023

Record deactivated on February 03, 2023

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Initial NPI Registration & Enumeration January 31, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376249516
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 31, 2023
Last Update: February 11, 2023
Deactivation Date: February 03, 2023
Sole Proprietor: Yes

Mailing Address

14751 Outlook St

Overland Park, KS 662231182

Phone: 9135686287

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.