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Deactivated NPI 1295835932 Deactivated / Inactive NPI Male Practitioner

Dr. Edward L. Jackson , DC

Chiropractor • Archie, MO

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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. Edward Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 23, 2006
NPI Deactivation Date June 14, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Edward Jackson, DC was a registered Chiropractor practicing in Archie, MO. Throughout an active medical career spanning 15 years, Dr. Jackson provided care at the practice location at 302 S WEST OUTER RD until profile deactivation on 2021-06-14.

Practice Location & Contact Primary Location

Practice Address

302 S West Outer Rd
Suite C

Archie, MO 647259710

Telephone 8162935539
Fax 8162935539

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Archie, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.4 Yrs
Regional Practice Density
1 Specialists

Practicing in Archie, MO (2674 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

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License MO 0003255

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.

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 Deactivated June 14, 2021

Record deactivated on June 14, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 302 S WEST OUTER RD, SUITE C, ARCHIE, MO 647259710 (Tel: 8162935539)

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Updated Business Mailing Address July 08, 2007

Registered at 302 S WEST OUTER RD, SUITE C, ARCHIE, MO 647259710 (Tel: 8162935539)

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Provider Name / Credentials Updated July 08, 2007

Recorded as EDWARD JACKSON, D C

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Chiropractor (License #0003255 in MO)

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Initial NPI Registration & Enumeration September 23, 2006

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: 1295835932
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 23, 2006
Last Update: July 08, 2007
Deactivation Date: June 14, 2021

Mailing Address

302 S West Outer Rd, Suite C

Archie, MO 647259710

Phone: 8162935539

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.