KENT R JACKSON MD
NPI 1871660613
Neuromusculoskeletal Medicine & OMM in Harbor City, CA

Q: What is Kent Jackson's NPI number?

The NPI number for Kent Jackson is 1871660613. It was assigned to this individual provider in the NPPES registry on November 29, 2006.

Q: What is Kent Jackson's specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine & OMM with taxonomy code 204D00000X.

Q: When was this NPI record last updated?

The NPPES record for Kent Jackson was last updated on November 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 November 29, 2006PECOS EnrolledAccepts Medicare Assignment

25825 VERMONT AVE, HARBOR CITY, CA 90710(310) 325-5111 Get Directions Write a Review

NPPES record last updated: November 30, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kent R Jackson Md NPPES

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

KENT R JACKSON MD (NPI 1871660613) is an individual neuromusculoskeletal medicine & omm provider in Harbor City, California, licensed in California (A78820) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, Geffen School Of Medicine (2000).

NPPES Registry Identity

NPI1871660613

Entity TypeIndividualMale

Primary Taxonomy204D00000X

Provider Legal NameKENT R JACKSONCredential: MD

Location Address25825 VERMONT AVEHarbor City, CA 90710-3518

Mailing Address25825 Vermont AveHarbor City, CA 90710-3518 · (310) 325-5111

Phone(310) 325-5111

Sole ProprietorNo

Medical School CMSUniversity Of California, Geffen School Of MedicineGraduated 2000

Enumeration DateNovember 29, 2006

Last NPPES UpdateNovember 30, 2021

✔ NPI 1871660613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeuromusculoskeletal Medicine & OMMAllopathic & Osteopathic Physicians

Taxonomy Code204D00000X

License✔ Licensed in CA · A78820

Definition

The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients.

25825 VERMONT AVE, Harbor City, CA 90710

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kent R Jackson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698835692

PECOS Enrollment IDI20081120000678

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 20

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

SEAN KOH PHARM.D.

Pharmacist