Raymond C Jackson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

17436 Issued in KY

Practice address

Pattie a Clay Regional Medical Center
Eastern Bypass
Richmond, KY 40476-2603

Phone

(859) 335-9041

Fax

(859) 335-9072

NPI assigned

Sep 6, 2006

Last updated

Jul 10, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Eastern Kentucky Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Pikeville, KY
  • NPI 1104870047
  NPD (past)
• Marshall Emergency Services Associates, PLLC

  • Emergency Medicine Physician
  • Lexington, KY
  • NPI 1891737185
  NPD (past)
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1043313026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 RIVA RIDGE RD",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758652",
            "telephone_number": "859-624-0355",
            "fax_number": "707-924-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PATTIE A CLAY REGIONAL MEDICAL CENTER",
            "address_2": "EASTERN BYPASS",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404762603",
            "telephone_number": "859-335-9041",
            "fax_number": "859-335-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RAYMOND",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "17436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ireland Army Community Hospital (Blue Grass Depot AHC)
• Krista Eloise Isaacs, NP
• Iscript Nutrition LLC
• J.C. Surgical Assisting
• Jeff Jackson, PHARMD
• Asad K Jadoon, MD
• Alexis Jaggers-Sparks
• Ginger Marie James-Wendel
• Megan Jameson, MA CF-SLP
• Kendra Jarnagin, RDN/LDN

• Emergency Medicine Physician in Richmond, KY
• Providers in Richmond, KY by specialty
• Emergency Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.