Active NPI
Casey Yates Jackson, P.A.
- Physician Assistant
- Magnolia, TX
National Provider Identifier
1013189901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA05689
- Practice address
- 18535 FM 1488 Rd
Suite 210
Magnolia, TX 77354-2700 - Phone
- (281) 789-7065
- Fax
- (866) 469-6650
- NPI assigned
- Mar 31, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA05689 | TX | Primary |
Addresses
Primary practice location
18535 FM 1488 Rd
Suite 210
Magnolia, TX 77354-2700
Mailing address
18535 FM 1488 Rd
Suite 210
Magnolia, TX 77354-2700
Phone (281) 789-7065
Other names 1
- Mrs. Casey Ray Yates
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paula Bailey MD PLLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Boerne, TX
- NPI 1083038798
-
- Urgent Care Clinic/Center
- Boerne, TX
- NPI 1255760054
-
- Urgent Care Clinic/Center
- Magnolia, TX
- NPI 1427482496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394668800000",
"number": "1013189901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18535 FM 1488 RD",
"address_2": "SUITE 210",
"city": "MAGNOLIA",
"state": "TX",
"postal_code": "773542700",
"telephone_number": "281-789-7065",
"fax_number": "866-469-6650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18535 FM 1488 RD",
"address_2": "SUITE 210",
"city": "MAGNOLIA",
"state": "TX",
"postal_code": "773542700",
"telephone_number": "281-789-7065",
"fax_number": "866-469-6650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CASEY",
"middle_name": "YATES",
"name_prefix": "Mrs.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-31",
"last_updated": "2014-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA05689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CASEY",
"last_name": "YATES",
"middle_name": "RAY",
"prefix": "MRS.",
"credential": "P.A.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Magnolia, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.