Active NPI
Marianne Jackson, DO
- Obstetrics & Gynecology Physician
- Berlin, NH
National Provider Identifier
1184626012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 6864
- Practice address
- 133 Pleasant St
Berlin, NH 03570-2006 - Phone
- (603) 752-2040
- Fax
- (603) 752-7797
- NPI assigned
- Aug 11, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 6864 | NH | Primary |
Addresses
Primary practice location
133 Pleasant St
Berlin, NH 03570-2006
Mailing address
133 Pleasant St
Berlin, NH 03570-2006
Phone (603) 752-2040
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| POOO91565 | Other | RAILROAD MEDICARE | |
| 30203596 | Medicaid | NH | |
| 0100920Y0NH02 | Other | NH | ANTHEM BC/BS |
| 6236954 | Other | NH | CIGNA HEALTHCARE |
| 5830418 | Other | AETNA GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6864 | NH | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coos County Family Health Services, Inc | Past | Accepting new patients | |
| Bladen Healthcare LLC | Past | Accepting new patients | |
| Coos County Family Health Services, Inc. | Past | Accepting new patients | |
| Coos County Family Health Services, Inc | Obstetrics & Gynecology | Past | Accepting new patients |
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.
-
- Federally Qualified Health Center (FQHC)
- Gorham, NH
- NPI 1275535999
-
- Federally Qualified Health Center (FQHC)
- Berlin, NH
- NPI 1346242054
Obstetrics & Gynecology
-
- Federally Qualified Health Center (FQHC)
- Berlin, NH
- NPI 1427050012
-
- Critical Access Hospital
- Elizabethtown, NC
- NPI 1558537282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1184626012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 PLEASANT ST",
"city": "BERLIN",
"state": "NH",
"postal_code": "035702006",
"telephone_number": "603-752-2040",
"fax_number": "603-752-7797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 PLEASANT ST",
"city": "BERLIN",
"state": "NH",
"postal_code": "035702006",
"telephone_number": "603-752-2040",
"fax_number": "603-752-7797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MARIANNE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-11",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "NH",
"license": "6864",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "POOO91565",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30203596",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "0100920Y0NH02",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "6236954",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA GROUP",
"identifier": "5830418",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Berlin, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.