1. Home
  2. Directory
  3. Indiana
  4. Polis
  5. Prosthetic Orthotic Supplier
  6. NPI Profile

EBONY JACKS
NPI 1104574896
Prosthetic/Orthotic Supplier in Indianapolis, IN

Active since March 13, 2022
1011 N ARLINGTON AVE, INDIANAPOLIS, IN 46219(260) 508-6752 Get Directions Write a Review

NPPES record last updated: June 7, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 7, 2022, Mar 13, 2022 (2 updates tracked since 2022).

About Ebony Jacks NPPES

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

EBONY JACKS (NPI 1104574896) is an individual prosthetic/orthotic supplier provider in Indianapolis, Indiana and active in the NPI registry since March 2022.

NPPES Registry Identity

NPI1104574896
Entity TypeIndividualFemale
Primary Taxonomy335E00000X
Provider Legal NameEBONY JACKS
Location Address1011 N ARLINGTON AVEIndianapolis, IN 46219-3223
Mailing Address1011 N Arlington AveIndianapolis, IN 46219-3223
Phone(260) 508-6752
Sole ProprietorYes
Enumeration DateMarch 13, 2022
Last NPPES UpdateJune 7, 20222 updates tracked since enumeration
NPPES CertifiedJune 7, 2022
✔ NPI 1104574896 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers
Taxonomy Code335E00000X
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
1011 N ARLINGTON AVE, Indianapolis, IN 46219
Open in Google Maps ↗

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 Ebony Jacks's NPI number?

The NPI number for Ebony Jacks is 1104574896. It was assigned to this individual provider in the NPPES registry on March 13, 2022.

Where is Ebony Jacks located?

Ebony Jacks practices at 1011 N Arlington Ave, Indianapolis, IN 46219. The listed phone number is (260) 508-6752.

What is Ebony Jacks's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

When was this NPI record last updated?

The NPPES record for Ebony Jacks was last updated on June 7, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.