Hershel Jackson, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

4301043930 Issued in MI

Practice address

3990 John R St
Detroit, MI 48201-2018

Phone

(313) 745-8040

NPI assigned

Feb 20, 2007

Sex

Male

Sole proprietor

No

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 MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Gastroenterology

Education

Wayne State University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
• Harper University Hospital Hospital, Detroit, MI, CCN 230104
• Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024
• Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hjackson2@direct.dmc.org
• Direct secure messaging: hjackson1133075@direct.hfhs.org

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.

• Hershel C Jackson MD PC

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1659536076
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation
• VHS Detroit Receiving Hospital Inc

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1619289998
  Care Compare affiliation
• VHS Harper-Hutzel Hospital Inc

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1427360700
  Care Compare affiliation
• VHS Sinai-Grace Hospital Inc

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1760794044
  Care Compare affiliation

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023153178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD STE 450",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753760",
            "telephone_number": "248-559-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HERSHEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301043930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frankie Dijonnay Anna-Marie Jackson
• Gloria Jackson, MSW
• Harumbee Fowler Jackson, OTR
• Helki Jackson
• Henry Benson Jackson, LLMSW
• James Jackson
• Jayne Jackson
• Jerry Camal Jackson, BA
• Jesse Jackson III, LLPC
• Jessica Glenn Jackson, CNM

• Endocrinology, Diabetes & Metabolism Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Endocrinology, Diabetes & Metabolism Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.