Crystal B Jackson, MD

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

700 Southlake Cir
Youngsville, LA 70592-5671

Phone

(703) 350-1912

NPI assigned

Jul 22, 2008

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

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

Anesthesiology

Education

Louisiana State University School of Medicine in New Orleans, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians

Jefferson Anesthesia ConsultantsGroup PAC ID 8820470057, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner University Hospital and Clinics Hospital, Lafayette, LA, CCN 190006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjackson233540@direct.ochsner.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 Anesthesia Consultants

  • Anesthesiology Physician
  • Kenner, LA
  • NPI 1639816374
  Medicare reassignment Care Compare group NPD
• Lafayette Health Ventures Inc

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1417986092
  Medicare reassignment Care Compare group NPD
• Louisiana State University School of Medicine in New Orleans Faculty G

  • Multi-Specialty Clinic/Center
  • New Orleans, LA
  • NPI 1477582526

  Specialist

  Medicare reassignment NPD
• Zephyr Anesthesia, LLC

  • Anesthesiology Physician
  • La Place, LA
  • NPI 1891087458
  Medicare reassignment NPD
• Lafayette Health Ventures Inc

  • Anesthesiology Physician
  • Jennings, LA
  • NPI 1063124568
  NPD
• Lafayette Health Ventures Inc.

  • Internal Medicine Physician
  • Lafayette, LA
  • NPI 1831780394

  Anesthesiology

  NPD
• Louisiana State University School of Medicine in New Orleans Faculty G

  • Durable Medical Equipment & Medical Supplies
  • Kenner, LA
  • NPI 1316417629
  NPD
• Lafayette Health Ventures, Inc

  • Internal Medicine Physician
  • Lafayette, LA
  • NPI 1467687186
  NPD (past)

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

• University Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1306281126
  Care Compare affiliation

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1083879837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SOUTHLAKE CIR",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925671",
            "telephone_number": "703-350-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SOUTHLAKE CIR",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925671",
            "telephone_number": "703-350-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CRYSTAL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-22",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "DC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00856598",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Integrative Medicine of Acadiana LLC
• Interim Benefits Consultants, LTD
• Emily Laszczak Inzerella, PT, DPT
• Leila Alexandra Irvan, RDN
• J Dauzart Anesthesia LLC
• Jacob Dent, D.D.S, Acadiana Dentists, a Professional Corporation
• Hannelore Susanne Jameson
• Randi Jenkins
• Jill Zerangue Simon, DDS (a Professional LLC)
• Breana Johnson

• Specialist in Youngsville, LA
• Providers in Youngsville, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.