Individual provider Active NPI

Jackson Vaughan Littlejohn, MD

  • Student in an Organized Health Care Education/Training Program
  • Arlington, TX
National Provider Identifier
1124604152
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3301 Matlock Rd
Arlington, TX 76015-2908
Phone
(817) 347-1141
NPI assigned
Mar 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X U8765 TX
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3301 Matlock Rd
Arlington, TX 76015-2908

Mailing address

3301 Matlock Rd
Arlington, TX 76015-2908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20241112001595 TX Practitioner - Internal Medicine 4486056595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of TX, PLLCGroup PAC ID 3274998067, 376 clinicians

Practice addresses (Care Compare)

12412 Judson Rd
Live Oak, TX 78233-3255
Phone (210) 757-7000

Hospital & facility affiliations

  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388
  • Methodist Hospital Stone Oak Hospital, San Antonio, TX, CCN 670055
  • Methodist Stone Oak Hospital Inpatient rehabilitation facility, San Antonio, TX, CCN 67T055
  • Methodist Hospital Northeast Inpatient rehabilitation facility, Live Oak, TX, CCN 45T388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
U8765TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of TX, PLLC CurrentSince Sep 1, 2024 Accepting new patients
Emergency Medicine Services of TX, PLLC CurrentSince Oct 5, 2024 Accepting new patients
Methodist Healthcare System of San Antonio, LTD., L.L.P. Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

12141 Richmond Ave
Houston, TX 77082
Phone (281) 558-3444

12412 Judson Rd
Live Oak, TX 78233
Phone (210) 646-5000

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

8026 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-8110

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

Interoperability endpoints

  • Direct secure messaging: jackson.littlejohn@hca7.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1124604152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 MATLOCK RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 MATLOCK RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152908",
            "telephone_number": "817-347-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLEJOHN",
        "first_name": "JACKSON",
        "middle_name": "VAUGHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-21",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U8765",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.