MR. KYLE RAYMOND JACKSON
NPI 1780329896
Student in an Organized Health Care Education/Training Program in Moraine, OH

Active since May 03, 2022
3095 KETTERING BLVD, MORAINE, OH 45439(937) 293-8300 Get Directions Write a Review

NPPES record last updated: June 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 19, 2025, Oct 12, 2024, May 3, 2022 (3 updates tracked since 2022).

About Mr. Kyle Raymond Jackson NPPES

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

MR. KYLE RAYMOND JACKSON (NPI 1780329896) is an individual student in an organized health care education/training program in Moraine, Ohio and active in the NPI registry since May 2022. He maintains a secondary practice location in Dayton.

NPPES Registry Identity

NPI1780329896
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. KYLE RAYMOND JACKSON
Location Address3095 KETTERING BLVDMoraine, OH 45439-1983
Mailing Address3640 Colonel Glenn Hwy, 117 Health Sciences BuildingDayton, OH 45435-0001 · (937) 775-3458
Sole ProprietorNo
Enumeration DateMay 3, 2022
Last NPPES UpdateJune 19, 20253 updates tracked since enumeration
NPPES CertifiedJune 19, 2025
NPI 1780329896 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
3095 KETTERING BLVD, Moraine, OH 45439

Secondary Practice Location 1

Location 13640 Colonel Glenn Hwy, 117 Health Sciences BuildingDayton, OH 45435-0001 · Phone (937) 775-3458

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.

Social Worker
3095 KETTERING BLVD
MORAINE, OH 45439
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Social Worker (Clinical)
3095 KETTERING BLVD
MORAINE, OH 45439
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Social Worker
3095 KETTERING BLVD
MORAINE, OH 45439
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439
Case Manager/Care Coordinator
3095 KETTERING BLVD
MORAINE, OH 45439

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 Kyle Jackson's NPI number?

The NPI number for Kyle Jackson is 1780329896. It was assigned to this individual provider in the NPPES registry on May 3, 2022.

Where is Kyle Jackson located?

Kyle Jackson practices at 3095 Kettering Blvd, Moraine, OH 45439. The listed phone number is (937) 293-8300.

What is Kyle Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Kyle Jackson was last updated on June 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.