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CORBY RYAN JACKSON
NPI 1639530215
Counselor - Professional in Dallas, TX

Active since March 10, 2016PECOS Enrolled
11300 N CENTRAL EXPY STE 400, DALLAS, TX 75243(844) 824-8775(281) 648-2200 Get Directions Write a Review

NPPES record last updated: September 10, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 10, 2024, Apr 12, 2020 (2 updates tracked since 2020).

About Corby Ryan Jackson NPPES

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

CORBY RYAN JACKSON (NPI 1639530215) is an individual professional provider in Dallas, Texas, licensed in Texas (95036) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1639530215
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameCORBY RYAN JACKSON
Location Address11300 N CENTRAL EXPY STE 400Dallas, TX 75243-6712
Mailing Address1225 Richards StJoliet, IL 60433-2745 · (708) 768-2144
Phone(844) 824-8775
Fax(281) 648-2200
Sole ProprietorNo
Enumeration DateMarch 10, 2016
Last NPPES UpdateSeptember 10, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2024
✔ NPI 1639530215 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in TX · 95036✔ Licensed in IL · 180.015589
11300 N CENTRAL EXPY STE 400, Dallas, TX 75243
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Secondary Practice Locations 2

Location 12319 Manhattan RdJoliet, IL 60433-8605 · Phone (815) 314-0533
Location 21225 Richards StJoliet, IL 60433-2745 · Phone (708) 768-2144

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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.

Other Providers at the Same Location NPPES 19

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

MADELINE CAVE RITCHIE LPCA
Counselor
11300 N CENTRAL EXPY STE 400
DALLAS, TX 75243
Dallas County (346) 584-6107
MEGAN BECKMAN LPC-A
Counselor (Mental Health)
11300 N CENTRAL EXPY STE 400
DALLAS, TX 75243
Dallas County (469) 579-2264
MARY GRACE DOWNS
Counselor (Mental Health)
11300 N CENTRAL EXPY STE 400
DALLAS, TX 75243
Dallas County (460) 607-0076
MRS. CHRISTINE ELIZABETH MAXWELL
Counselor (Professional)
11300 N CENTRAL EXPY STE 400
DALLAS, TX 75243
Dallas County (469) 607-0076
MRS. AMBER JOHNSON LCSW
Social Worker (Clinical)
11300 N CENTRAL EXPY STE 400
DALLAS, TX 75243
Dallas County (903) 360-3507
MADISON MILLER
Student in an Organized Health Care Education/Training Program
11300 N CENTRAL EXPY STE 400
DALLAS, TX 75243
Dallas County (888) 504-2947
MR. JASON CHADDERDON LPC ASSOCIATE
Counselor (Professional)
11300 N CENTRAL EXPY STE 400
DALLAS, TX 75243
Dallas County (469) 607-0076
KELSEY LEA LPC-A
Counselor (Mental Health)
11300 N CENTRAL EXPY STE 400
DALLAS, TX 75243
Dallas County (469) 607-0076

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 Corby Jackson's NPI number?

The NPI number for Corby Jackson is 1639530215. It was assigned to this individual provider in the NPPES registry on March 10, 2016.

Where is Corby Jackson located?

Corby Jackson practices at 11300 N Central Expy Ste 400, Dallas, TX 75243. The listed phone number is (844) 824-8775.

What is Corby Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Corby Jackson enrolled in Medicare?

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

What insurance does Corby Jackson accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Corby Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Corby Jackson was last updated on September 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.