Rebecca Jackson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

208092 Issued in MA

Practice address

119 New Athol Rd Ste 200
Orange, MA 01364-9603

Phone

(978) 544-7800

NPI assigned

Feb 7, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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.

• Community Health Center of Franklin County Incorporated

  • Federally Qualified Health Center (FQHC)
  • Greenfield, MA
  • NPI 1457300329

  Family Medicine

  Medicare reassignment NPD
• Community Health Center of Franklin County Incorporated

  • Federally Qualified Health Center (FQHC)
  • Turners Falls, MA
  • NPI 1093566069
  NPD
• Community Health Center of Franklin County Incorporated

  dba Health Center Pharmacy

  • Community/Retail Pharmacy
  • Orange, MA
  • NPI 1427873520
  NPD
• Daf Medical Associates Inc

  • Internal Medicine Physician
  • East Falmouth, MA
  • NPI 1548212558
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114999786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 NEW ATHOL RD STE 200",
            "city": "ORANGE",
            "state": "MA",
            "postal_code": "013649603",
            "telephone_number": "978-544-7800",
            "fax_number": "978-544-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 NEW ATHOL RD STE 200",
            "city": "ORANGE",
            "state": "MA",
            "postal_code": "013649603",
            "telephone_number": "978-544-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 W River St",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "MA",
            "postal_code": "013641435",
            "country_code": "US",
            "telephone_number": "978-544-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2022-07-21",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "208092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110083655A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MA",
            "identifier": "J23829",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCARE",
            "identifier": "AA159101",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "47759",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9611148",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Hart, LICSW
• Terri-Lynne Haydocy
• Kathleen Anne Hazelton, MA
• Maria Jones Heidenreich, N.P.
• Suzann P. Heron
• Javad Mirzai DMD PLLC
• Katie Mae Johnson
• Manish Juneja, DMD
• Kathleen Louise Korb, LMHC
• Debra Marie Kott, LICSW

• Family Medicine Physician in Orange, MA
• Providers in Orange, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.