Niki Rose Jackson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

T4184 Issued in TX

Practice address

3032 Marina Bay Dr Ste 200
League City, TX 77573-4668

Phone

(832) 604-6534

Fax

(832) 604-6531

NPI assigned

May 11, 2017

Last updated

Dec 11, 2024By the provider in NPPES

Sex

Female

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

Internal Medicine

Education

University of Texas Medical School at Houston, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dayal Family Medicine PAGroup PAC ID 6901223817, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Houston Methodist Clear Lake Hospital Hospital, Nassau Bay, TX, CCN 450709
• HCA Houston Healthcare Clear Lake Hospital, Webster, TX, CCN 450617

Medicare enrollment (NPD)

Enrolled

Credentials

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dayal Family Medicine PA

  • Family Medicine Physician
  • League City, TX
  • NPI 1376152538
  Medicare reassignment Care Compare group NPD
• Kelsey-Seybold Medical Group, PLLC

  dba Kelsey Seybold Clinic

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255

  Internal Medicine

  Medicare reassignment NPD
• Clear Lake Primary Care PLLC

  • Family Medicine Physician
  • Webster, TX
  • NPI 1861743247

  Internal Medicine

  NPD (past)

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

• Chca Clear Lake LP

  dba HCA Houston Healthcare Clear Lake

  • General Acute Care Hospital
  • Webster, TX
  • NPI 1063466035
  Care Compare affiliation
• Houston Methodist St. John Hospital

  dba Houston Methodist Clear Lake Hospital

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1952723967
  Care Compare affiliation

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1083140891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3032 MARINA BAY DR STE 200",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775734668",
            "telephone_number": "832-604-6534",
            "fax_number": "832-604-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3032 MARINA BAY DR STE 200",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775734668",
            "telephone_number": "832-604-6534",
            "fax_number": "832-604-6531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2727 W Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770251669",
            "country_code": "US",
            "telephone_number": "713-442-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 S Ponds Dr",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "TX",
            "postal_code": "775981409",
            "country_code": "US",
            "telephone_number": "713-442-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "NIKI",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T4184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Thomas Carroll DDS PC (Todays Dentistry League City)
• Nyesha Jaunee Jackson-Cavil
• Katrina Marie Jackson, PA-C
• Kayla Jackson
• Kimberly Jackson, LPC
• Tracie Jackson, D.D.S.
• Elizabeth O'Meara Jacobs, RDN, LD
• Jacquelyn Strait, PH.D., PC
• Leslie E. Jakubas, RN, CRNA
• James D Miller DC LLC (Miller Atlas Chiropractic)

• Internal Medicine Physician in League City, TX
• Providers in League City, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.