Ronnie Lee Jackson, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

MD020868 Issued in TN

Practice address

100 Northcrest Dr
Springfield, TN 37172-3927

Phone

(615) 384-2411

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmcrjackso@yourcarecommunity.org

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.

• Ronnie L. Jackson MD

  • Specialist
  • Springfield, TN
  • NPI 1659771350
  NPD (past) Authorized official
• Hospital Medicine Services of TN, LLC

  • Hospitalist Physician
  • Nashville, TN
  • NPI 1982301065
  NPD
• Springfield Health Services, LLC

  • General Acute Care Hospital
  • Springfield, TN
  • NPI 1093397184
  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1174500896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTHCREST DR",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371723927",
            "telephone_number": "615-384-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTHCREST DR",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371723927",
            "telephone_number": "615-384-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RONNIE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "MD020868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3077609",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Intelligent Therapy Staffing Inc
• Intelligent Therapy Staffing, Inc.
• Maria Irizarry
• Chris Edward Jackson, D.C.
• Robert Jackson
• Stephanie Jackson, OTR/L
• Amy Jacky, PMHNP
• John Jason James, DO
• Austin Leigh Jarrell, MS
• Tiffany Jarrell, PA

• All providers in Springfield, TN
• Pulmonary Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.