William Jackson, D.O.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

82162 Issued in SC

Practice address

101 S Ravenel St Ste 230
Florence, SC 29506-2624

Phone

(843) 777-7043

Fax

(843) 777-7041

NPI assigned

May 9, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Vascular Surgery

Education

West Virginia School of Osteopathic Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Cora South Carolina LLCGroup PAC ID 3173766334, shared by 6 NPIs, 220 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLeod Home Health Inc Home health agency, Florence, SC, CCN 427057
• McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051
• McLeod Health Clarendon Hospital, Manning, SC, CCN 420109
• McLeod Health Cheraw Hospital, Cheraw, SC, CCN 420107
• McLeod Medical Center - Dillon Hospital, Dillon, SC, CCN 420005
• McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wjackson32088@directmcleodehealth.org
• Direct secure messaging: williamc.jackson@mpaii.eclinicaldirectplus.com

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.

• McLeod Physician Associates II

  • Family Medicine Physician
  • Florence, SC
  • NPI 1801990494
  Medicare reassignment Care Compare group NPD
• McLeod Physician Associates II

  • Orthopaedic Surgery Physician
  • Florence, SC
  • NPI 1922555739
  NPD
• McLeod Physician Associates II

  • Family Medicine Physician
  • Dillon, SC
  • NPI 1568434249
  NPD (past)
• McLeod Regional Medical Center of the Pee Dee, Inc.

  • General Acute Care Hospital
  • Florence, SC
  • NPI 1699756221
  NPD (past)

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

• McLeod Health Cheraw

  • General Acute Care Hospital
  • Cheraw, SC
  • NPI 1902283740
  Care Compare affiliation
• McLeod Health Clarendon

  • Rural Acute Care Hospital
  • Manning, SC
  • NPI 1205284411
  Care Compare affiliation
• McLeod Loris Seacoast Hospital

  • General Acute Care Hospital
  • Loris, SC
  • NPI 1306123344
  Care Compare affiliation
• McLeod Medical Center-Dillon

  • General Acute Care Hospital
  • Dillon, SC
  • NPI 1598746141
  Care Compare affiliation
• McLeod Regional Medical Center of the Pee Dee, Inc

  • Home Health Agency
  • Florence, SC
  • NPI 1215991682
  Care Compare affiliation
• McLeod Regional Medical Center of the Pee Dee, Inc.

  • General Acute Care Hospital
  • Florence, SC
  • NPI 1699756221
  Care Compare affiliation

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1104237338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S RAVENEL ST STE 230",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062624",
            "telephone_number": "843-777-7043",
            "fax_number": "843-777-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S RAVENEL ST STE 230",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062624",
            "telephone_number": "843-777-7043",
            "fax_number": "843-777-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "WILLIAM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-09",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SC",
            "license": "82162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "williamc.jackson@mpaii.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "ECW DA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "101 S Ravenel St Ste 230",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295062624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cradeja Shovon Jackson
• Haley Meharg Jackson, CPNP
• Kristin Gayle Jackson
• Latisha Simone Jackson, LPC
• Sholonda Jackson, RN
• Denise Jacobs, FNP
• Jennifer Langston Jacobs, RPH
• Kendall Jacobs, PT, DPT
• Kristin Cook Jacobs, MCD, CCC-SLP
• Tiffany Jacobs

• Vascular Surgery Physician in Florence, SC
• Providers in Florence, SC by specialty
• Vascular Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.