Paul Jackson, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5298 Issued in TN

Practice address

600 Elizabeth St, Gme
Corpus Christi, TX 78404

Phone

(361) 861-1864

NPI assigned

Mar 27, 2018

Last updated

Aug 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, KY, TN3 enrollments

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 3

Specialty

Emergency Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Middle Tennessee Emergency Physicians, P.C.Group PAC ID 3678464526, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013
• Saint Thomas Highlands Hospital Hospital, Sparta, TN, CCN 440192
• Saint Thomas River Park Hospital Hospital, McMinnville, TN, CCN 440151
• Dekalb Community Hospital Hospital, Smithville, TN, CCN 440148

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Middle Tennessee Emergency Physicians PC

  • Emergency Medicine Physician
  • Nashville, TN
  • NPI 1194758979
  Medicare reassignment Care Compare group NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382
  Medicare reassignment Care Compare group NPD
• Guadalupe Emergency Medicine Associates, PA

  • Emergency Medicine Physician
  • Alice, TX
  • NPI 1114425220
  Medicare reassignment NPD
• Kentucky Post-Acute Medical Services 1 PSC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Flemingsburg, KY
  • NPI 1831628783

  Hospitalist

  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  Internal Medicine, KY

  Medicare reassignment NPD
• Conner Emergency Medicine Associates, PA

  • Emergency Medicine Physician
  • Corpus Christi, TX
  • NPI 1013415934
  Medicare reassignment

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

• Bowling Green-Warren County Community Hospital Corporation

  dba The Medical Center

  • General Acute Care Hospital
  • Bowling Green, KY
  • NPI 1043293608
  Care Compare affiliation
• Saint Thomas Dekalb Hospital, LLC

  dba Ascension Saint Thomas Dekalb

  • General Acute Care Hospital
  • Smithville, TN
  • NPI 1649659582
  Care Compare affiliation
• Saint Thomas Highlands Hospital, LLC

  dba Ascension Saint Thomas Highlands

  • General Acute Care Hospital
  • Sparta, TN
  • NPI 1922487966
  Care Compare affiliation
• Saint Thomas River Park Hospital, LLC

  dba Ascension Saint Thomas River Park

  • General Acute Care Hospital
  • McMinnville, TN
  • NPI 1518346469
  Care Compare affiliation
• Saint Thomas River Park Hospital, LLC

  dba Ascension Saint Thomas River Park

  • Ambulatory Surgical Clinic/Center
  • McMinnville, TN
  • NPI 1558742304

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1114422599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ELIZABETH ST, GME",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78404",
            "telephone_number": "361-861-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ELIZABETH ST, GME",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78404",
            "telephone_number": "361-861-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "PAUL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "05035",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "5298",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "05035",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "05035",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bria Jackson
• Donna G Jackson, FNP MSN
• James Richard Jackson, PA-C
• Joel Jackson, LPC,CPO
• Leah Jackson, PTA
• Phillip Jackson, M.D.
• Taylor Catherine Jackson
• Jacob J Moore MD PA (Coastal Bend Eye Center)
• Jacob M Thompson DDS PC
• Nikhita Susan Jacob

• Emergency Medicine Physician in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.