Ilana Jackson, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05059 Issued in MD

Practice address

1 Sunny Meadow CT
Apt 102
Baltimore, MD 21209-1255

Phone

(908) 839-7117

NPI assigned

Jan 31, 2012

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

66.41 of 100Reported as group

Quality

30.12

Promoting interoperability

80

Improvement activities

40

Cost

57.93

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Jackson Therapy Services LLC

  • Clinical Psychologist
  • Towson, MD
  • NPI 1669921193
  Medicare reassignment NPD Authorized official
• Sheppard Pratt Physicians, P.a.

  • Psychiatry Physician
  • Baltimore, MD
  • NPI 1518990712
  Medicare reassignment NPD

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1104198522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 ALLEGHENY AVE",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212044256",
            "telephone_number": "908-839-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SUNNY MEADOW CT",
            "address_2": "APT 102",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212091255",
            "telephone_number": "908-839-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ILANA",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-31",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebony Jackson
• Eric Jackson, M.D.
• Eric Michael Jackson, MD
• Faith Jackson
• Guy Jackson, M.D.
• India Beatrice Sojourner Jackson, LGPC
• Iris Jackson, LCSW-C
• Jade Ariana Jackson
• Jaila Jackson
• Jamilah Jackson, LGSW

• Clinical Psychologist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.