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Canon Jackson, BS
NPI 1568080133 · Behavior Technician · Bowling Green, KY
Canon Jackson, BS is a Behavior Technician provider in Bowling Green, KY (NPI 1568080133).
Provider details
- NPI number
- 1568080133
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Credential
- BS
- Sex
- Male
- Sole proprietor
- No
- License
- RBT-20-115930 (KY)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2427 Russellville Rd
Bowling Green, KY 42101-3980
Phone: (270) 936-7472
Fax: (317) 520-8200
Street-level locationGet directions
Mailing address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Registry dates
- Enumerated
- 2020-07-10
- Last updated
- 2020-07-10
- Certified
- 2020-07-10
Frequently asked questions
- What is Canon Jackson's NPI number?
- Canon Jackson's National Provider Identifier (NPI) is 1568080133, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Canon Jackson's specialty?
- Canon Jackson is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).
- Where is Canon Jackson located?
- Canon Jackson's practice location on file with NPPES is 2427 Russellville Rd, Bowling Green, KY 42101-3980.
- What is Canon Jackson's phone number?
- The practice phone number listed in the NPPES registry for Canon Jackson is (270) 936-7472.
- Is Canon Jackson's NPI active?
- Yes — Canon Jackson's NPI (1568080133) is active in the NPPES registry as of the last update on 2020-07-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.