DR. KYLE SEBASTIAN JACKSON (DC) – Chiropractor, NPI 1669085718

DR. KYLE SEBASTIAN JACKSON (DC) is a healthcare provider. based in Jacksonville, Florida. specializing in CHIROPRACTIC. They hold the professional credentials DC. They hold a License No. CH13208 (FL). The NPI Number for DR. KYLE SEBASTIAN JACKSON (DC) is 1669085718

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
DR. KYLE SEBASTIAN JACKSON (DC)
NPI
1669085718
Phone
(904) 645-0777
Address
12620 BEACH BLVD STE 6
Enumeration Date
28 August 2020
Last Update Date
28 August 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9046450777
Graduation Year
2012 (14 years ago)
PAC ID
5294154738
Group Practice PAC ID
9234376690
Professional Enrollment ID
I20201001002214
Address ID
FL322467130JA12620BLVD305

Contacts

Main Contact
stafmpcc@gmail.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

2,472 CHIROPRACTIC in FL

Provider Addresses for DR. KYLE SEBASTIAN JACKSON (DC)

  • 12620 BEACH BLVD STE 6

    JACKSONVILLE, FL 322467130

    Phone: (904) 645-0777

    Fax: (904) 645-3483

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-10-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201001002214IChiropracticFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98941Chiropractic manipulative treatment, 3-4 spinal regions776158$0
98942Chiropractic manipulative treatment, 5 spinal regions15988$0
98940Chiropractic manipulative treatment, 1-2 spinal regions7768$0
View full utilization report →

Insurance plans in this area (ZIP 32246)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9234376690View full group profile
NameSpecialtyState
C H I R O P R A C T I CFL
-FL
-FL
C H I R O P R A C T I CFL
C H I R O P R A C T I CFL

Reviews

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Frequently asked questions

How do payers reference DR. KYLE SEBASTIAN JACKSON (DC)?
For DR. KYLE SEBASTIAN JACKSON (DC), use NPI 1669085718 as the unique 10-digit identifier.
Would DR. KYLE SEBASTIAN JACKSON (DC) appear as active to a payer?
You can treat DR. KYLE SEBASTIAN JACKSON (DC) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DR. KYLE SEBASTIAN JACKSON (DC)?
DR. KYLE SEBASTIAN JACKSON (DC)'s specialty line reads Chiropractor. Clinical services aligned with this taxonomy classification.
Is DR. KYLE SEBASTIAN JACKSON (DC) associated with Jacksonville?
Public fields place DR. KYLE SEBASTIAN JACKSON (DC) around Jacksonville, Florida. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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