Naima K Jackson, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

C0002405 Issued in MD

Practice address

7300 Van Dusen Rd
Laurel Regional Hospital
Laurel, MD 20707

Phone

(301) 497-7940

Fax

(301) 497-8743

NPI assigned

Dec 3, 2007

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 MD, DC2 enrollments

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 2

Specialty

Physician Assistant

Education

Howard University College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dimensions Healthcare Associates, IncGroup PAC ID 1557269743, 198 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: njackson801595@direct.umm.edu

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.

• Dimensions Healthcare Associates, Inc.

  • Anesthesiology Physician
  • Largo, MD
  • NPI 1346354834

  DC

  Medicare reassignment Care Compare group
• St Agnes Healthcare Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1144250176
  Medicare reassignment NPD
• Dimensions Health Associates Dba University of Maryland Capital Region

  • Internal Medicine Physician
  • Oxon Hill, MD
  • NPI 1407486293
  NPD
• Dimensions Healthcare Associates Inc

  • Cardiovascular Disease Physician
  • Laurel, MD
  • NPI 1538220512
  NPD
• St Agnes Healthcare Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1780615922
  NPD

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1083896948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 GATESHEAD MANOR WAY",
            "address_2": "#301",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209046136",
            "telephone_number": "301-890-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 VAN DUSEN RD",
            "address_2": "LAUREL REGIONAL HOSPITAL",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "301-497-7940",
            "fax_number": "301-497-8743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "NAIMA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0002405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breana M Jackson, PTA
• Deborah A Jackson
• Frank R. Jackson, M.D.
• Kirsten Tamara Jackson, LCPC
• Kiti Jackson
• Nkolika Jackson, PT
• Shonta Jackson
• Steven Matt Jacques
• Todd Darrin Jaeblon, DO
• Teeda Jagne-Saine

• Surgical Physician Assistant in Laurel, MD
• Providers in Laurel, MD by specialty
• Surgical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.