DR. VAN RIEVES JACKSON IV D.P.M.
NPI 1851634877
Student in an Organized Health Care Education/Training Program in New Haven, CT

Q: What is Van Jackson's NPI number?

The NPI number for Van Jackson is 1851634877. It was assigned to this individual provider in the NPPES registry on March 27, 2013.

Q: What is Van Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Van Jackson was last updated on September 4, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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 March 27, 2013

360 STATE ST APT 1708, NEW HAVEN, CT 06510(214) 336-5860 Get Directions Write a Review

NPPES record last updated: September 4, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Van Rieves Jackson Iv D.p.m. NPPES

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

DR. VAN RIEVES JACKSON IV D.P.M. (NPI 1851634877) is an individual student in an organized health care education/training program in New Haven, Connecticut and active in the NPI registry since March 2013.

NPPES Registry Identity

NPI1851634877

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. VAN RIEVES JACKSON IVCredential: D.P.M.

Location Address360 STATE ST APT 1708New Haven, CT 06510-3614

Mailing Address360 State St Apt 1708New Haven, CT 06510-3614 · (214) 336-5860

Phone(214) 336-5860

Sole ProprietorNo

Enumeration DateMarch 27, 2013

Last NPPES UpdateSeptember 4, 2013

✔ NPI 1851634877 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

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.

360 STATE ST APT 1708, New Haven, CT 06510

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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 Van Jackson's NPI number?

The NPI number for Van Jackson is 1851634877. It was assigned to this individual provider in the NPPES registry on March 27, 2013.

Where is Van Jackson located?

Van Jackson practices at 360 State St Apt 1708, New Haven, CT 06510. The listed phone number is (214) 336-5860.

What is Van 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 Van Jackson was last updated on September 4, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.