RICHARD T JACKSON D.P.M.
NPI 1407859424
Podiatrist in Fort Wayne, IN

Q: What is Richard Jackson's NPI number?

The NPI number for Richard Jackson is 1407859424. It was assigned to this individual provider in the NPPES registry on May 23, 2005.

Q: What is Richard Jackson's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Q: When was this NPI record last updated?

The NPPES record for Richard Jackson was last updated on November 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.

Active since May 23, 2005

7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804(260) 436-8686(260) 486-8585 Get Directions Write a Review

NPPES record last updated: November 7, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Richard T Jackson D.p.m. NPPES

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

RICHARD T JACKSON D.P.M. (NPI 1407859424) is an individual podiatrist in Fort Wayne, Indiana, licensed in Indiana (07000729A) and active in the NPI registry since May 2005.

NPPES Registry Identity

NPI1407859424

Entity TypeIndividualMale

Primary Taxonomy213E00000X

Provider Legal NameRICHARD T JACKSONCredential: D.P.M.

Location Address7601 W JEFFERSON BLVDFort Wayne, IN 46804-4133

Mailing AddressPo Box 2526Fort Wayne, IN 46801-2526 · (260) 436-8686 · Fax (260) 436-8585

Phone(260) 436-8686

Fax(260) 486-8585

Sole ProprietorNo

Enumeration DateMay 23, 2005

Last NPPES UpdateNovember 7, 2016

✔ NPI 1407859424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers

Taxonomy Code213E00000X

License✔ Licensed in IN · 07000729A

Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

7601 W JEFFERSON BLVD, Fort Wayne, IN 46804

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Other Identifiers 5

Medicaid100359040AIN

Other480026551Railroad Medicare

Other00000089403Anthem

Medicare UPINU21698IN

Medicare PIN665600BIN

Other Providers at the Same Location NPPES 20

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

GAGE MANNING CAUDELL D.P.M.

Podiatrist (Foot & Ankle Surgery)