Atiba Diarra Jackson, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

35.089443 Issued in OH

Practice address

4160 Little York Rd
Ste 10
Dayton, OH 45414-5803

Phone

(937) 415-9100

Fax

(937) 415-9191

NPI assigned

May 22, 2007

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 OH

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

Orthopedic SurgeryAlso: Sports Medicine

Education

Cincinnati College of Medicine and Surgery, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Associates of SW Ohio IncGroup PAC ID 9638258874, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Buckeye Home Health Care, LLC Home health agency, Dayton, OH, CCN 368197
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Wilson Memorial Hospital Hospital, Sidney, OH, CCN 360013
• Fort Hamilton Hughes Memorial Hospital Hospital, Hamilton, OH, CCN 360132

Merit-based Incentive Payment System (MIPS)

Final score

83.43 of 100Reported as group

Quality

70.97

Promoting interoperability

98

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: atiba.jackson@oaswo.eclinicaldirectplus.com

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.

• Orthopedic Associates of SW Ohio, Inc

  • Orthopaedic Surgery Physician
  • Dayton, OH
  • NPI 1447422118
  Medicare reassignment Care Compare group NPD
• Dayton Osteopathic Hospital

  • Multi-Specialty Clinic/Center
  • Dayton, OH
  • NPI 1588630347
  Medicare reassignment NPD
• Mercy Health Physicians Springfield Specialty Care LLC

  • Surgery Physician
  • Springfield, OH
  • NPI 1790308104

  Orthopaedic Surgery

  Medicare reassignment NPD
• Dayton Osteopathic Hospital

  • Specialty Pharmacy
  • Kettering, OH
  • NPI 1629511688
  NPD
• Orthopedic Associates of S W Ohio Inc,

  • Orthopaedic Surgery Physician
  • Fairborn, OH
  • NPI 1609387984
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Buckeye Home Health Care LLC

  • Home Health Agency
  • Dayton, OH
  • NPI 1699879601
  Care Compare affiliation
• Dayton Osteopathic Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Shelby County Memorial Hospital Association Inc.

  • General Acute Care Hospital
  • Sidney, OH
  • NPI 1639174204
  Care Compare affiliation
• The Fort Hamilton Hospital

  • General Acute Care Hospital
  • Hamilton, OH
  • NPI 1104867167
  Care Compare affiliation

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1033329990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 LITTLE YORK RD",
            "address_2": "STE 10",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454145803",
            "telephone_number": "937-415-9100",
            "fax_number": "937-415-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 LITTLE YORK RD",
            "address_2": "STE 10",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454145803",
            "telephone_number": "937-415-9100",
            "fax_number": "937-415-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ATIBA",
        "middle_name": "DIARRA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35.089443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Jackson Vicente, LMT
• Aaliyah Jackson
• Alexa Jackson
• Alexandria Jackson, RDN, LD
• Amanda Jackson
• Bertha E Jackson
• Billy Jerome Jackson
• Brenda Lynn Jackson, B.S. BUSINESS
• Carl'Averis Jackson
• Carroll S Jackson, L.I.S.W.

• Orthopaedic Surgery Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Orthopaedic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.