John G Jackson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD019331 Issued in LA

Practice address

13030 Highway 308
Larose, LA 70373-2001

Phone

(985) 798-7000

Fax

(985) 798-7021

NPI assigned

Dec 7, 2005

Last updated

Jan 30, 2023By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Family Practice

Education

Tulane University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lafourche Parish Hospital Service District No 1Group PAC ID 2264342229, shared by 7 NPIs, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lady of the Sea General Hospital Hospital, Cut Off, LA, CCN 191325

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/748/brand/4/csg/25/fhir/r4
• Direct secure messaging: john.jackson.1@748.direct.athenahealth.com

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.

• Lafourche Parish Hospital Service District No. 1

  dba Lady of the Sea Medical Clinic - Larose

  • Rural Health Clinic/Center
  • Larose, LA
  • NPI 1932256542

  Family Medicine

  Medicare reassignment NPD
• Lafourche Parish Hospital Service District No.1

  dba Lady of the Sea Physician Group

  • Emergency Medicine Physician
  • Cut Off, LA
  • NPI 1831260793
  Medicare reassignment NPD
• Lafourche Parish Hospital Service District No. 1

  dba Lady of the Sea Community Pharmacy #1

  • Community/Retail Pharmacy
  • Cut Off, LA
  • NPI 1285021519
  NPD (past)
• Lafourche Parish Hospital Service District No.1

  dba Lady of the Sea General Hospital

  • Critical Access Hospital
  • Cut Off, LA
  • NPI 1922005842
  NPD (past)

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

• Lafourche Parish Hospital Service District No.1

  dba Lady of the Sea General Hospital

  • Critical Access Hospital
  • Cut Off, LA
  • NPI 1407883341
  Care Compare affiliation

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1063497683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13030 HIGHWAY 308",
            "city": "LAROSE",
            "state": "LA",
            "postal_code": "703732001",
            "telephone_number": "985-798-7000",
            "fax_number": "985-798-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13030 HIGHWAY 308",
            "city": "LAROSE",
            "state": "LA",
            "postal_code": "703732001",
            "telephone_number": "985-798-7000",
            "fax_number": "985-798-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOHN",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD15556",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD019331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030589",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elmo Charles Gautreaux, PHARMACIST
• Jennifer Guidry, PT
• Sabrina Hagar
• Kellie Hebert
• Deanna Simoncelli Hodson, FNP-C
• Jay Vega MD.,a.P.M.C.
• Lafourche Parish Hospital Service District No. 1 (Lady of the Sea Community Pharmacy #2)
• Lafourche Parish Hospital Service District No. 1 (Lady of the Sea Medical Clinic - Larose)
• Rebecca Gates Ledet, M. A. CCC-SLP
• Shana Matherne

• Family Medicine Physician in Larose, LA
• Providers in Larose, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.