Active NPI
Anthony Robert Jackson, DO
- Emergency Medicine Physician
- Mobile, AL
National Provider Identifier
1124879457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- DO.4412
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240731003783 | AL | Order and Referring Only - 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
| License | State | Type | Specialty |
|---|---|---|---|
| DO.4412 | AL | MD | Emergency 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.