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DR. JACKSON K DRAEGER DC
NPI 1073012290
Chiropractor in Green Bay, WI

Active since February 02, 2018
827 CORMIER RD, GREEN BAY, WI 54304(920) 569-2350 Get Directions Write a Review

NPPES record last updated: March 1, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 1, 2021, Mar 17, 2018 (2 updates tracked since 2018).

About Dr. Jackson K Draeger Dc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACKSON K DRAEGER DC (NPI 1073012290) is an individual chiropractor in Green Bay, Wisconsin, licensed in Wisconsin (5321-12) and active in the NPI registry since February 2018. He maintains a secondary practice location in Antigo and is a graduate of Other (2017).

NPPES Registry Identity

NPI1073012290
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. JACKSON K DRAEGERCredential: DC
Location Address827 CORMIER RDGreen Bay, WI 54304-4706
Mailing Address827 Cormier RdGreen Bay, WI 54304-4706 · (920) 569-2350 · Fax (920) 569-2333
Phone(920) 569-2350
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateFebruary 2, 2018
Last NPPES UpdateMarch 1, 20212 updates tracked since enumeration
NPPES CertifiedMarch 1, 2021
✔ NPI 1073012290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in WI · 5321-12
Definition
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.
827 CORMIER RD, Green Bay, WI 54304
Open in Google Maps ↗

Secondary Practice Location 1

Location 1N2120 County Rd SAntigo, WI 54409-8950 · Phone (920) 569-2350

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jackson K Draeger Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335495423
PECOS Enrollment IDI20180703000598

Medicare Billing Reassignment

Medicare enrollment records show Jackson Draeger reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gold Medal Group, LLC
Same address
Chiropractor
827 CORMIER RD
Green Bay, WI 54304
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2 clinicians in this Medicare group
NPI 1114513652 (920) 569-2350

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 1-2 spinal regions 98940
Chiropractic manipulative treatment focuses on adjusting your spine to improve your body's physical function. In this service, a chiropractor applies controlled force to 1-2 spinal regions. This helps to restore mobility and alleviate discomfort in those areas.
394 services24 patients

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GOLD MEDAL GROUP, LLC
Chiropractor
827 CORMIER RD
GREEN BAY, WI 54304
Brown County (920) 569-2350
DR. CARLI GREEN DC
Chiropractor
827 CORMIER RD
GREEN BAY, WI 54304
Brown County (920) 569-2350
INTEGRATED PAIN SOLUTIONS LLC
Clinic/Center
827 CORMIER RD
GREEN BAY, WI 54304
Brown County (920) 569-2350

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Draeger's NPI number?

The NPI number for Jackson Draeger is 1073012290. It was assigned to this individual provider in the NPPES registry on February 2, 2018.

Where is Jackson Draeger located?

Jackson Draeger practices at 827 Cormier Rd, Green Bay, WI 54304. The listed phone number is (920) 569-2350.

What is Jackson Draeger's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Jackson Draeger enrolled in Medicare?

Yes. Jackson Draeger is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jackson Draeger's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jackson Draeger reassigns Medicare benefits to Gold Medal Group, LLC (Green Bay, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jackson Draeger's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jackson Draeger was last updated on March 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.