Individual provider Active NPI

Anthony Robert Jackson, DO

  • Emergency Medicine Physician
  • Mobile, AL
National Provider Identifier
1124879457
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO.4412 Issued in AL
Practice address
181 Hillcrest Rd
Mobile, AL 36608-5306
Phone
(251) 341-3800
Fax
(251) 660-6333
NPI assigned
Mar 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO.4412 AL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

181 Hillcrest Rd
Mobile, AL 36608-5306

Mailing address

PO Box 746450
Atlanta, GA 30374-6450
Phone (866) 401-3057

Other practice location 1

2451 University Hospital Dr Rm 714
Mobile, AL 36617-2300
Phone (251) 471-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240731003783 AL Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 0143767749

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Alabama College of Osteopathic Medicine, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

650 Clinic Dr
Mobile, AL 36688

PO Box
Suite 74645
Atlanta, GA 30374-6450

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO.4412ALMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1124879457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746450",
            "telephone_number": "866-401-3057",
            "fax_number": "318-868-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 HILLCREST RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366085306",
            "telephone_number": "251-341-3800",
            "fax_number": "251-660-6333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2451 University Hospital Dr Rm 714",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366172300",
            "country_code": "US",
            "telephone_number": "251-471-7000",
            "fax_number": "251-471-7096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANTHONY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-27",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "DO.4412",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.