NPIMap

Individual provider Active NPI

Frank Wilson Jackson III, MD

  • Gastroenterology Physician
  • Camp Hill, PA
National Provider Identifier
1164421673
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD055416L Issued in PA
Practice address
423 N 21St St
Suite 100
Camp Hill, PA 17011-2207
Phone
(717) 761-0930
Fax
(717) 761-0465
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD055416L PA Primary

Addresses

Primary practice location

423 N 21St St
Suite 100
Camp Hill, PA 17011-2207

Mailing address

423 N 21St St
Suite 100
Camp Hill, PA 17011-2207
Phone (717) 761-0930

Other identifiers 6

IdentifierTypeStateIssuer
01024101OtherPACAPITAL BLUE CROSS
0016834680003MedicaidPA
5333615OtherPAAETNA US HEALTHCARE
G84061OtherPAHEALTHAMERICA
527552OtherPAHIGHMARK BLUE SHIELD
100012586OtherPARAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fwilsonjackson@jg.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050512000016 PA Practitioner - Gastroenterology 1456310432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Northwestern University Feinberg Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Siegelbaum Gastroenterology LTDGroup PAC ID 5799769139, 10 clinicians

Practice addresses (Care Compare)

423 N 21St St
Suite 100
Camp Hill, PA 17011-2207
Phone (717) 761-0930

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy173
Upper gastrointestinal (GI) endoscopy for acid reflux163

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD055416LPAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Siegelbaum Gastroenterology LTD Gastroenterology CurrentSince Jan 22, 1997 Accepting new patients
West Shore Endoscopy Center LLC CurrentSince May 26, 2019 Accepting new patients
Capital Anesthesia LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

423 N 21st St
Ste 102
Camp Hill, PA 17011
Phone (717) 525-6488

423 N 21st St
Ste 100
Camp Hill, PA 17011
Phone (717) 238-3111

200 Grandview Ave
Ste 101
Camp Hill, PA 17011

4387 Sturbridge Dr
Harrisburg, PA 17110
Phone (717) 238-3111

Interoperability endpoints

  • Direct secure messaging: fwilsonjackson@jg.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCHDD

Organizations & group practices 4

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1164421673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 N 21ST ST",
            "address_2": "SUITE 100",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112207",
            "telephone_number": "717-761-0930",
            "fax_number": "717-761-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 N 21ST ST",
            "address_2": "SUITE 100",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112207",
            "telephone_number": "717-761-0930",
            "fax_number": "717-761-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "FRANK",
        "middle_name": "WILSON",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD055416L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "01024101",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016834680003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "5333615",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHAMERICA",
            "identifier": "G84061",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "527552",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100012586",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fwilsonjackson@jg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "423 N 21st St",
            "address_2": "Suite 100",
            "city": "Camp Hill",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170112207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

Verify at the official NPI Registry.