Clintonia Jackson, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

ME66277 Issued in FL

Practice address

5 Memorial Medical CT
Greenville, SC 29605-4449

Phone

(864) 272-3409

NPI assigned

Dec 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Clintonia Box Former name

Medicare fee-for-service enrollment

Enrolled in FL, SC2 enrollments

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 2

Specialty

Anesthesiology

Education

University of Miami, LM Miller School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spartanburg Medical CenterGroup PAC ID 3072425297, shared by 17 NPIs, 1,060 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.7 of 100Reported as apm

Quality

89.4

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Spartanburg Medical Center

  • Neuromusculoskeletal Medicine & OMM Physician
  • Spartanburg, SC
  • NPI 1043309917
  Medicare reassignment NPD
• Spartanburg Medical Center

  • Emergency Medicine Physician
  • Spartanburg, SC
  • NPI 1699729939
  Medicare reassignment NPD
• Spartanburg Medical Center

  • Surgery Physician
  • Greer, SC
  • NPI 1760114664
  Medicare reassignment NPD
• Under Anesthesia

  • Anesthesiology Physician
  • Sumter, SC
  • NPI 1194018242
  Medicare reassignment NPD
• East Coast Anesthesia Associates PA

  • Anesthesiology Physician
  • Port St Lucie, FL
  • NPI 1770756256
  Medicare reassignment NPD
• Medstream Anesthesia PLLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1649616160

  SC

  Medicare reassignment NPD
• Spartanburg Medical Center

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1326373697
  NPD
• Spartanburg Medical Center

  • Anesthesiology Physician
  • Spartanburg, SC
  • NPI 1760155808
  NPD
• Spartanburg Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1942188875
  NPD
• Innovative Medical Staffing Solutions Inc

  • Certified Registered Nurse Anesthetist
  • Orlando, FL
  • NPI 1629308713

  Anesthesiology

  NPD
• Jay Godines, LLC

  • Anesthesiology Physician
  • Sumter, SC
  • NPI 1831498559
  NPD (past)
• Brevard Physician Associates, PLLC

  • Anesthesiology Physician
  • Melbourne, FL
  • NPI 1598008955
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1164585790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 PELHAM RD",
            "address_2": "PMB 145",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296155044",
            "telephone_number": "321-698-7637",
            "fax_number": "307-316-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEMORIAL MEDICAL CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054449",
            "telephone_number": "864-272-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CLINTONIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME66277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000042300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLINTONIA",
            "last_name": "BOX",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Sue Jackson, RPH
• Ande M Jackson, MS,CNC
• Candace Smith Jackson, LPC
• Carolyn E Jackson
• Charles Anthony Jackson
• Cornelia Yvette Jackson
• Elizabeth Jackson, LPC-A
• Hannah J Jackson
• Joanna Jackson
• Karen Mehlman Jackson, PHARMD

• Anesthesiology Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Anesthesiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.

Verify at the official NPI Registry.