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Deactivated NPI 1417050212 Deactivated / Inactive NPI Male Practitioner

Melvyn Lewis Jackson

Chiropractor • Johnson City, TN

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

Registration / Start Date September 07, 2006
NPI Deactivation Date November 06, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Melvyn Jackson was a registered Chiropractor practicing in Johnson City, TN. Throughout an active medical career spanning 14 years, Melvyn Jackson provided care at the practice location at 809 S. ROAN STREET until profile deactivation on 2020-11-06.

Practice Location & Contact Primary Location

Practice Address

809 S. Roan Street
Suite #3

Johnson City, TN 37601

Telephone 4239297444
Fax 4239297444

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Johnson City, TN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 21.7 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
38 Specialists

Practicing in Johnson City, TN (1601 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 TN DC0000000296

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 November 06, 2020

Record deactivated on November 06, 2020

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 809 S. ROAN STREET, SUITE #3, JOHNSON CITY, TN 37601 (Tel: 4239297444)

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Updated Business Mailing Address July 08, 2007

Registered at 809 S. ROAN STREET, SUITE #3, JOHNSON CITY, TN 37601 (Tel: 4239297444)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MELVYN JACKSON

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

Chiropractor (License #DC0000000296 in TN)

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Initial NPI Registration & Enumeration September 07, 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: 1417050212
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 07, 2006
Last Update: July 08, 2007
Deactivation Date: November 06, 2020

Mailing Address

809 S. Roan Street, Suite #3

Johnson City, TN 37601

Phone: 4239297444

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.