Brian Jeffry Jackson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95010531 Issued in CA

Practice address

2075 San Joaquin Hills Rd
Newport Beach, CA 92660-6505

Phone

(949) 760-9222

NPI assigned

Feb 27, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospitalist Medicine Physicians of New Mexico - Clovis LLCGroup PAC ID 0345618849, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presbyterian Santa Fe Medical Center Hospital, Santa Fe, NM, CCN 320090

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Hospitalist Medicine Physicians of New Mexico - Clovis, LLC

  • Emergency Medicine Physician
  • Hobbs, NM
  • NPI 1477031094
  Medicare reassignment Care Compare group NPD

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

• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1730684853
  Care Compare affiliation

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1174080030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 MARQUETTE PL APT 4C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921061059",
            "telephone_number": "541-550-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 SAN JOAQUIN HILLS RD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606505",
            "telephone_number": "949-760-9222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Marquette Pl Apt 4C",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921061059",
            "country_code": "US",
            "telephone_number": "541-550-6572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRIAN",
        "middle_name": "JEFFRY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95010531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Robert West, M.D., Inc
• J. Donald Turner, D.D.S., Inc.
• J. Michael Leary, M.D., Inc
• Ja Hospice
• Janaia Jabril
• Carol A Jackson, M.D.
• Dajah Jackson
• Jecoliah Jackson, RBT
• Melissa Grace Jackson
• Jacob Reznik MD and Alena Reznik MD a Prof Corp

• Family Nurse Practitioner in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.