Erin Atwater Jackson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2114 Issued in NC

Practice address

415 Semora Rd
Roxboro, NC 27573-5185

Phone

(336) 599-0246

Fax

(336) 597-3356

NPI assigned

Aug 27, 2008

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

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patty Vision Center OD PAGroup PAC ID 0143200584, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Patty Vision Center OD PA

  • Optometrist
  • Yanceyville, NC
  • NPI 1497798177
  Medicare reassignment Care Compare group
• Patty Vision Center OD PA

  • Optometrist
  • Burlington, NC
  • NPI 1548217755
  NPD

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1184871626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 SEMORA RD",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275735185",
            "telephone_number": "336-599-0246",
            "fax_number": "336-597-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 SEMORA RD",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275735185",
            "telephone_number": "336-599-0246",
            "fax_number": "336-597-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ERIN",
        "middle_name": "ATWATER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910510",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Integrative Communtiy Solutions, LLC
• J-1 Consultants LLC
• J-1 Consultants LLC
• Brianna Elizabeth Jackson
• Charles Bartlett Jackson Jr.
• Nathan Oscar Jackson, MD
• James R Devillier MD PC
• Rebecca Jean Baptiste
• Matthew Jennings, MSSW
• Johnson Allied Health Services Inc

• Optometrist in Roxboro, NC
• Providers in Roxboro, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.