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MATTHEW ADRIAN JACKMAN
NPI 1891071973
Counselor - Addiction (Substance Use Disorder) in Salt Lake City, UT

Active since November 02, 2011PECOS EnrolledAccepts Medicare Assignment
447 BEARCAT DR, SALT LAKE CITY, UT 84115(801) 355-2846(801) 359-3244 Get Directions Write a Review

NPPES record last updated: November 2, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Matthew Adrian Jackman NPPES

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

MATTHEW ADRIAN JACKMAN (NPI 1891071973) is an individual addiction (substance use disorder) provider in Salt Lake City, Utah and active in the NPI registry since November 2011. He is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1891071973
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMATTHEW ADRIAN JACKMAN
Location Address447 BEARCAT DRSalt Lake City, UT 84115-2519
Mailing Address447 Bearcat DrSalt Lake City, UT 84115-2519 · (801) 355-2846 · Fax (801) 359-3244
Phone(801) 355-2846
Fax(801) 359-3244
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateNovember 2, 2011
✔ NPI 1891071973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
447 BEARCAT DR, Salt Lake City, UT 84115
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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

Matthew Adrian Jackman 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 ID6305333816
PECOS Enrollment IDI20251016003626
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 5

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

EMMA GRATTEAU APC
Counselor (Professional)
447 BEARCAT DR
SALT LAKE CITY, UT 84115
Salt Lake County (801) 355-2846
BRISA K AYUB
Student in an Organized Health Care Education/Training Program
447 BEARCAT DR
SALT LAKE CITY, UT 84115
Salt Lake County (801) 355-2846
EDWARD JAMES VARLEY
Counselor (Addiction (Substance Use Disorder))
447 BEARCAT DR
SALT LAKE CITY, UT 84115
Salt Lake County (801) 824-6358
JANA CLAIRE FULMER MSC, CMHC
Counselor (Mental Health)
447 BEARCAT DR
SALT LAKE CITY, UT 84115
Salt Lake County (801) 355-2846
CRAIG BRYCE ANDERSON CSW
Counselor (Addiction (Substance Use Disorder))
447 BEARCAT DR
SALT LAKE CITY, UT 84115
Salt Lake County (801) 355-2846

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 Matthew Jackman's NPI number?

The NPI number for Matthew Jackman is 1891071973. It was assigned to this individual provider in the NPPES registry on November 2, 2011.

Where is Matthew Jackman located?

Matthew Jackman practices at 447 Bearcat Dr, Salt Lake City, UT 84115. The listed phone number is (801) 355-2846.

What is Matthew Jackman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Matthew Jackman enrolled in Medicare?

Yes. Matthew Jackman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Matthew Jackman was last updated on November 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.