NATHAN ROBERT JACKSON IDC NPI 1134790728

NPI Information

  • NPI: 1134790728
  • Provider Name: NATHAN ROBERT JACKSON, IDC
  • Classification: Military Health Care Provider - 1710I1002X
  • Specialization: Independent Duty Corpsman
  • Entity Type: Individual
  • Address: 730 FORRESTAL ST BLDG 3775
    KINGSVILLE, TX
    ZIP 78363
  • Phone: (361) 516-6266

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NPI Details

Nathan Robert Jackson, IDC is an independent duty corpsman military health care provider in Kingsville, TX. The provider is a Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. Nathan Robert Jackson, IDC NPI is 1134790728. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

730 FORRESTAL ST BLDG 3775
KINGSVILLE, TX
ZIP 78363-112
Phone: (361) 516-6266

The enumeration date for this NPI number is 7/6/2021 and was last updated on 1/6/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11710I1002XMilitary Health Care ProviderIndependent Duty CorpsmanYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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