Angela Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60638952 Issued in WA

Practice address

915 Sheridan St.
Port Townsend, WA 98368

Phone

(360) 379-8031

Fax

(360) 379-4383

NPI assigned

Apr 30, 2014

Sex

Female

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 WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson County Public Hospital District No 2Group PAC ID 4789593708, 151 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: acecil636202@wm.providencedirect.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.

• Jefferson County Public Hospital District No 2

  • Critical Access Hospital
  • Port Townsend, WA
  • NPI 1356492953
  Medicare reassignment Care Compare group
• Jefferson County Public Hospital District No 2

  • Rural Health Clinic/Center
  • Port Townsend, WA
  • NPI 1952353369
  NPD
• Jefferson County Public Hospital District No 2

  • Rural Health Clinic/Center
  • Port Townsend, WA
  • NPI 1902850753
  NPD (past)

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

• Jefferson County Public Hospital District No 2

  • Medicare Defined Swing Bed Hospital Unit
  • Port Townsend, WA
  • NPI 1104950039
  Care Compare affiliation
• Jefferson County Public Hospital District No 2

  • Critical Access Hospital
  • Port Townsend, WA
  • NPI 1356492953
  Care Compare affiliation
• Jefferson County Public Hospital District No 2

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Silverdale, WA
  • NPI 1467664631

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1073923975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "98368",
            "telephone_number": "360-379-8031",
            "fax_number": "360-379-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 SHERIDAN ST.",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "98368",
            "telephone_number": "360-379-8031",
            "fax_number": "360-379-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60638952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald W. Irick II, D.O.
• Sarah Irick, ARNP
• Natalie Susan Irwin, MPT
• Ruby Connolly Isaac
• Craig Isenberg, MA, LMFTA
• Dolores P, Jacoby, M.S.W., D. DIV,PH.D.
• James O Cunnington DDS
• Claus Henner Janssen, M.D.
• Christopher Yashpal Jayne, N.D.
• Joanna Judith Jech

• Physician Assistant in Port Townsend, WA
• Providers in Port Townsend, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.