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JACKSON PRIMARY CARE LLC
NPI 1790213676
Clinic/Center - Primary Care in Jackson, MO

Active since May 23, 2017
2685 E MAIN ST STE A, JACKSON, MO 63755(573) 204-1400(573) 204-1480 Get Directions Write a Review

NPPES record last updated: May 25, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jackson Primary Care Llc NPPES

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

JACKSON PRIMARY CARE LLC (NPI 1790213676) is a healthcare organization registered as a primary care in Jackson, Missouri and active in the NPI registry since May 2017. The organization lists Joan L Mayberry, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1790213676
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameJACKSON PRIMARY CARE LLC
Location Address2685 E MAIN ST STE AJackson, MO 63755-2474
Mailing Address2685 E Main St Ste AJackson, MO 63755-2474 · (573) 204-1400 · Fax (573) 204-1480
Phone(573) 204-1400
Fax(573) 204-1480
Organization SubpartNo
Authorized OfficialJoan L MayberryOffice Manager · (573) 204-1400
Enumeration DateMay 23, 2017
Last NPPES UpdateMay 25, 2017
✔ NPI 1790213676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedClinic/Center · Rural HealthTaxonomy 261QR1300X · License 106442 (MO)
2685 E MAIN ST STE A, Jackson, MO 63755
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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 Jackson Primary Care LLC's NPI number?

The NPI number for Jackson Primary Care LLC is 1790213676. It was assigned to this organization in the NPPES registry on May 23, 2017.

Where is Jackson Primary Care LLC located?

Jackson Primary Care LLC is located at 2685 E Main St Ste A, Jackson, MO 63755. The listed phone number is (573) 204-1400.

What is Jackson Primary Care LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Jackson Primary Care LLC was last updated on May 25, 2017. 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.