Christopher M Jackson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704247130 Issued in MI

Practice address

302 Kensington Ave
Flint, MI 48503-2044

Phone

(810) 762-8400

NPI assigned

Nov 28, 2018

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 MI

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

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cancer and Hematology Centers of Western Mi, P.C.Group PAC ID 4082526793, 109 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hurley Medical Center Hospital, Flint, MI, CCN 230132

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

96

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjackson1133061@direct.hfhs.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.

• Cancer & Hematology Centers of Western Mi, P.C.

  • Specialist
  • Grand Rapids, MI
  • NPI 1528018389
  Medicare reassignment Care Compare group NPD
• Genesee Cancer and Blood Disease Treatment Center PC

  • Hematology & Oncology Physician
  • Flint, MI
  • NPI 1912068453
  Medicare reassignment NPD
• Cancer & Hematology Centers of Western Mi, P.C.

  • Rheumatology Physician
  • Grand Rapids, MI
  • NPI 1467017434
  NPD

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

• Hurley Medical Center

  • General Acute Care Hospital
  • Flint, MI
  • NPI 1598717480
  Care Compare affiliation

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1093285496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 PINE ST",
            "city": "CORUNNA",
            "state": "MI",
            "postal_code": "488171031",
            "telephone_number": "810-449-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 KENSINGTON AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032044",
            "telephone_number": "810-762-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Pine St",
            "address_purpose": "LOCATION",
            "city": "Corunna",
            "state": "MI",
            "postal_code": "488171031",
            "country_code": "US",
            "telephone_number": "810-449-0566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-28",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704247130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tariq I M O J Tamimi, MD
• J. E. Ryan Enterprise, Inc.
• Muhammad A Jabbar, M.D.
• Briana N Jackson
• Cheryl Jackson
• Courtney M Jackson
• Danika Dashawn Jackson
• Dewayne Jackson, PERSONAL TRAINER
• Emily Ann Jackson, LLMSW
• Jaquoya Jackson

• Family Nurse Practitioner in Flint, MI
• Providers in Flint, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.