Mark D Jackson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2187 Issued in CO

Practice address

1250 E Magnolia St
Fort Collins, CO 80524-2702

Phone

(970) 224-0606

Fax

(970) 493-9309

NPI assigned

Jul 5, 2005

Reactivated

Mar 31, 2006

Last updated

May 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Eyecare, PCGroup PAC ID 7911896378, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• CO HMO
• devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
• CO HMO D-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jackson Eyecare, PC

  dba Jackson Eye Care

  • Optometrist
  • Fort Collins, CO
  • NPI 1396878328
  Medicare reassignment Care Compare group NPD Authorized official
• Foco Eye Care, LLC

  • Optometrist
  • Fort Collins, CO
  • NPI 1821923244
  NPD Authorized official
• Jackson Eye Care, PC

  • Optometrist
  • Fort Collins, CO
  • NPI 1912721440
  NPD Authorized official
• Mark D. Jackson, OD and Assoc., PC

  dba Jackson Eye Care

  • Optometrist
  • Loveland, CO
  • NPI 1831316090
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1023015005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E MAGNOLIA ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242702",
            "telephone_number": "970-224-0606",
            "fax_number": "970-493-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MAGNOLIA ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242702",
            "telephone_number": "970-224-0606",
            "fax_number": "970-493-9309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1037 Robertson St",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805243926",
            "country_code": "US",
            "telephone_number": "970-224-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Marie Jackson, FNP
• Emily R Jackson
• Jillian K Jackson, MA, RP
• Joseph L Jackson, DDS, MS
• Kristin Ann Monnat Jackson, CRNA
• Matthew Wayne Jackson, M.D.
• Michelle Jackson, NNP
• Rebecca Rain Jackson, DO
• Reuben Jackson
• Wesley P Jackson, MD

• Optometrist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.