William Jackson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9300722 Issued in NC

Practice address

1656 Riverchase Blvd
Suite 2400
Rock Hill, SC 29732-2084

Phone

(803) 329-5131

NPI assigned

Jul 21, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Shiland Family Medicine

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1124357124
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1124049978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 RIVERCHASE BLVD",
            "address_2": "SUITE 2400",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322084",
            "telephone_number": "803-329-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "10912",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9300722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1656 Riverchase Blvd",
            "address_2": "Suite 2400",
            "city": "Rock Hill",
            "state": "SC",
            "country_code": "US",
            "postal_code": "297322084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Breanna Jackson, RBT
• Margaret Jackson
• Marsha D Jackson, M.ED.,L.M.S.W.,L.P.C
• Michael Latrelle Jackson
• Tiffany Denise Jackson, MD
• Amanda Kristen Jacobs, PHARMD
• Brittany Jacobs, DPT
• Jag28 LLC
• Jam Medical Services, LLC
• Sheri Jamal, MD

• Family Medicine Physician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.