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KYLER JACKSON
NPI 1386216703
Social Worker in Ann Arbor, MI

Active since July 14, 2021PECOS Enrolled
4788 WASHTENAW AVE APT B7, ANN ARBOR, MI 48108(717) 808-7198 Get Directions Write a Review

NPPES record last updated: May 26, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 26, 2022, Jul 14, 2021 (2 updates tracked since 2021).

About Kyler Jackson NPPES

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

KYLER JACKSON (NPI 1386216703) is an individual social worker in Ann Arbor, Michigan, licensed in Michigan (6851114487) and active in the NPI registry since July 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1386216703
Entity TypeIndividualMale
Primary Taxonomy104100000X
Provider Legal NameKYLER JACKSON
Location Address4788 WASHTENAW AVE APT B7Ann Arbor, MI 48108-3113
Mailing Address415 Glensprings Dr Ste 201Cincinnati, OH 45246-2353 · (513) 771-9600
Phone(717) 808-7198
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 14, 2021
Last NPPES UpdateMay 26, 20222 updates tracked since enumeration
NPPES CertifiedMay 26, 2022
✔ NPI 1386216703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
Licenses✔ Licensed in MI · 6851114487✔ Licensed in OH · S.2101858-TRNE
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
4788 WASHTENAW AVE APT B7, Ann Arbor, MI 48108
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kyler Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8426520404
PECOS Enrollment IDI20260611000720
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Kyler Jackson's NPI number?

The NPI number for Kyler Jackson is 1386216703. It was assigned to this individual provider in the NPPES registry on July 14, 2021.

Where is Kyler Jackson located?

Kyler Jackson practices at 4788 Washtenaw Ave Apt B7, Ann Arbor, MI 48108. The listed phone number is (717) 808-7198.

What is Kyler Jackson's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Kyler Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Kyler Jackson was last updated on May 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.