Active NPI
Allison M Jackson, MD, MPH
- Pediatrics Physician
- Washington, DC
National Provider Identifier
1124100334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD22029
- Practice address
- 111 Michigan Ave NW
Washington, DC 20010-2978 - Phone
- (202) 476-4100
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD22029 | DC | Primary |
Addresses
Primary practice location
111 Michigan Ave NW
Washington, DC 20010-2978
Mailing address
PO Box 37215
Baltimore, MD 21297-3215
Phone (301) 572-1323
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6720587 | Medicaid | VA | |
| 690003800 | Medicaid | MD | |
| 028181800 | Medicaid | DC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD22029 | DC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Children's Hospital
- Washington, DC
- NPI 1912939703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1124100334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 37215",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212973215",
"telephone_number": "301-572-1323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MICHIGAN AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102978",
"telephone_number": "202-476-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ALLISON",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD, MPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DC",
"license": "MD22029",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6720587",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "690003800",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "028181800",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.