Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1396044269 Individual Practitioner Female Practitioner

Keely Jackson , CERTIFIED

Specialist • Macomb, MI

Professional Overview & Biography Verified Profile Summary

Keely Jackson, CERTIFIED is a registered healthcare professional specializing in Specialist in Macomb, MI. Practice services are available at 21268 VENICE DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

21268 Venice Dr

Macomb, MI 480441315

Telephone 5869488954
Fax 5869488954

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Macomb, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 37.1 Yrs
Regional Practice Density
2 Specialists

Practicing in Macomb, MI (867 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

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License CO 911223

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active March 17, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location March 17, 2011

Registered at 21268 VENICE DR, MACOMB, MI 480441315 (Tel: 5869488954)

📍
Updated Business Mailing Address March 17, 2011

Registered at 21268 VENICE DR, MACOMB, MI 480441315 (Tel: 5869488954)

👤
Provider Name / Credentials Updated March 17, 2011

Recorded as KEELY JACKSON, CERTIFIED

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2011

Specialist (License #911223 in CO)

🟢
Initial NPI Registration & Enumeration March 17, 2011

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: 1396044269
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 17, 2011
Last Update: March 17, 2011
Sole Proprietor: No

Mailing Address

21268 Venice Dr

Macomb, MI 480441315

Phone: 5869488954

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.