Russell Brent Jackson, D.O.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

P5384 Issued in TX

Practice address

155 E Sonterra Blvd Ste 111
San Antonio, TX 78258-3988

Phone

(210) 729-1900

Fax

(210) 729-1901

NPI assigned

Feb 18, 2009

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 TX

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 Surgery

Education

University of North Texas HSC, College of Osteopathic Med, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

R Brent Jackson DO PAGroup PAC ID 6204057821, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospital Stone Oak Hospital, San Antonio, TX, CCN 670055
• Baptist Medical Center Hospital, San Antonio, TX, CCN 450058

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• R Brent Jackson DO PA

  • Orthopaedic Surgery Physician
  • San Antonio, TX
  • NPI 1598174427
  Medicare reassignment Care Compare group NPD

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

• Methodist Healthcare System of San Antonio LTD LLP

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1659525236
  Care Compare affiliation
• VHS San Antonio Partners LLC

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1598744856
  Care Compare affiliation

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1073752879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 593377",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782590218",
            "telephone_number": "210-494-9600",
            "fax_number": "210-494-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E SONTERRA BLVD STE 111",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583988",
            "telephone_number": "210-729-1900",
            "fax_number": "210-729-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RUSSELL",
        "middle_name": "BRENT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-18",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "P5384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Jackson, LVN
• Rhonda Jackson
• Richard Blair Jackson Jr., M.D.
• Robert Jackson, M.D.
• Ronald Eliot Jackson, LICENSED PTA
• Sha-Risa Jackson
• Shantell Jackson
• Shaun Chadrick Jackson, MD
• Sheryd J. Jackson, RNC, MS, WHNP
• Stephanie Renee Jackson, OTR

• Orthopaedic Surgery Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.