NPIMap

Individual provider Active NPI

Keegan Marie Jackson, M.D.

  • Family Medicine Physician
  • Juneau, AK
National Provider Identifier
1104143072
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7867 Issued in AK
Practice address
3245 Hospital Dr
Juneau, AK 99801-7809
Phone
(907) 463-4040
NPI assigned
Apr 30, 2010
Sex
Female
Sole proprietor
No

Organizations & group practices 16

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.

Hospital & facility affiliations 37

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

View all 37

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Alaska Regional Health Consortium 373 clinicians

Practice addresses (Care Compare)

1204 Seward Ave
Searhc 1204 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611

1206 Seward Ave
Searhc 1206 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611

1209 Seward Ave
Searhc 1209 Behavioral
Sitka, AK 99835-7359
Phone (907) 966-8611

222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

227 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

28 Dock St
Searhc Gustavus Clinic
Gustavus, AK 99826-0399
Phone (907) 697-3008

3245 Hospital Dr
Juneau, AK 99801-7809
Phone (907) 463-4040

641 W Willoughby Ave
201 Searhc Internal Med
Juneau, AK 99801-1748
Phone (907) 586-8100

Hospital & facility affiliations

  • Southeast Alaska Regional Health Consortium Hospital, Sitka, AK, CCN 021314
  • Bartlett Regional Hospital Hospital, Juneau, AK, CCN 020008
  • Wildflower Court Nursing home, Juneau, AK, CCN 025027

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20151207000819 TX Practitioner - Family Practice 5698948578 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7867AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Alaska Regional Health Consortium CurrentSince Sep 19, 2015 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Sep 19, 2015 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients
Bartlett Regional Hospital Past Accepting new patients
Bartlett Regional Hospital Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients

Locations

37 Chilkat Ave
Haines, AK 99827
Phone (907) 463-4040

3260 Hospital Dr
Juneau, AK 99801
Phone (907) 796-8427

1200 Salmon Creek Ln
Juneau, AK 99801
Phone (907) 463-4031

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

3245 Hospital Dr
Juneau, AK 99801
Phone (907) 463-4040

2000 Salmon Creek Ln
Juneau, AK 99801
Phone (907) 463-8700

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DHEABD
  • Direct secure messaging: keeganj@direct-searhc.org

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 54140 MN
Family Medicine Physician 207Q00000X 7867 AK Primary

Addresses

NPPES NPI Registry

Primary practice location

3245 Hospital Dr
Juneau, AK 99801-7809

Mailing address

3100 Channel Dr Ste 300
Juneau, AK 99801-7837
Phone (907) 463-4040

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 14, 2015.

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1104143072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 CHANNEL DR STE 300",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017837",
            "telephone_number": "907-463-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017809",
            "telephone_number": "907-463-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KEEGAN",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "54140",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "7867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, AK

Sources for this page

Verify at the official NPI Registry.