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DR. JON C JACKSON M.D.
NPI 1093724551
Specialist in Port Orange, FL

Active since August 05, 2006
4770 S RIDGEWOOD AVE, PORT ORANGE, FL 32127(386) 761-0050(386) 761-1167 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Jon C Jackson M.d. NPPES

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

DR. JON C JACKSON M.D. (NPI 1093724551) is an individual specialist in Port Orange, Florida, licensed in Florida (ME28054) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1093724551
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. JON C JACKSONCredential: M.D.
Location Address4770 S RIDGEWOOD AVEPort Orange, FL 32127-4544
Mailing Address4770 S Ridgewood AvePort Orange, FL 32127-4544 · (386) 761-0050 · Fax (386) 761-1167
Phone(386) 761-0050
Fax(386) 761-1167
Sole ProprietorYes
Enumeration DateAugust 5, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1093724551 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in FL · ME28054
Definition

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.

4770 S RIDGEWOOD AVE, Port Orange, FL 32127
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Other Identifiers 4

Other64353FL · Blue Cross Blue Shield
Medicare ID-Type UnspecifiedK2665FL · Medicare Group#
Medicare UPIND57653FL
Other013FL · Cigna

Other Providers at the Same Location NPPES 7

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

PRIMARY CARE CENTER OF PORT ORANGE
Family Medicine
4770 S RIDGEWOOD AVE, SUITE 1
PORT ORANGE, FL 32127
Volusia County (386) 761-0050
PRIMARY CARE OF PORT ORANGE
Health Maintenance Organization
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 761-4670
VICKIE LYNN SORRELL FNP-BC
Nurse Practitioner (Family)
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 761-0050
MRS. LIANA NOELLE MENENDEZ LCSW
Counselor (Mental Health)
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 259-8071
INSIGHTFUL THERAPEUTIC SOLUTIONS LLC
Counselor (Mental Health)
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 259-8071
EDWARD MERKLE
Counselor (Mental Health)
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 416-9767
MARILYN B DELUERA LCSW
Counselor (Mental Health)
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Volusia County (386) 425-3900

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 Jon Jackson's NPI number?

The NPI number for Jon Jackson is 1093724551. It was assigned to this individual provider in the NPPES registry on August 5, 2006.

Where is Jon Jackson located?

Jon Jackson practices at 4770 S Ridgewood Ave, Port Orange, FL 32127. The listed phone number is (386) 761-0050.

What is Jon Jackson's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Jon Jackson was last updated on July 9, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.