CHAD EDWIN JACKSON MS, ATC
NPI 1518484245
Preventive Medicine - Sports Medicine in Fort Myers, FL

Q: What is Chad Jackson's NPI number?

The NPI number for Chad Jackson is 1518484245. It was assigned to this individual provider in the NPPES registry on August 24, 2017.

Q: What is Chad Jackson's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Sports Medicine, with taxonomy code 2083S0010X.

Q: When was this NPI record last updated?

The NPPES record for Chad Jackson was last updated on August 24, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 August 24, 2017

14110 SIX MILE CYPRESS PKWY, FORT MYERS, FL 33912(239) 479-6411(239) 768-2032 Get Directions Write a Review

NPPES record last updated: August 24, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Chad Edwin Jackson Ms, Atc NPPES

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

CHAD EDWIN JACKSON MS, ATC (NPI 1518484245) is an individual sports medicine provider in Fort Myers, Florida, licensed in Florida (AL2986) and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1518484245

Entity TypeIndividualMale

Primary Taxonomy2083S0010X

Provider Legal NameCHAD EDWIN JACKSONCredential: MS, ATC

Location Address14110 SIX MILE CYPRESS PKWYFort Myers, FL 33912-4314

Mailing Address618 Se 3rd StCape Coral, FL 33990-1109 · (239) 292-7669

Phone(239) 479-6411

Fax(239) 768-2032

Sole ProprietorYes

Enumeration DateAugust 24, 2017

✔ NPI 1518484245 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPreventive Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2083S0010X

License✔ Licensed in FL · AL2986

Definition

A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries.

14110 SIX MILE CYPRESS PKWY, Fort Myers, FL 33912

Open in Google Maps ↗

Other Providers at the Same Location NPPES

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

AXEL LOPEZ

Specialist/Technologist (Athletic Trainer)

14110 SIX MILE CYPRESS PKWY
FORT MYERS, FL 33912

Lee County (570) 801-0492

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 Chad Jackson's NPI number?

The NPI number for Chad Jackson is 1518484245. It was assigned to this individual provider in the NPPES registry on August 24, 2017.

Where is Chad Jackson located?

Chad Jackson practices at 14110 Six Mile Cypress Pkwy, Fort Myers, FL 33912. The listed phone number is (239) 479-6411.

What is Chad Jackson's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Sports Medicine, with taxonomy code 2083S0010X.

When was this NPI record last updated?

The NPPES record for Chad Jackson was last updated on August 24, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.