Jackson Macdonald, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.007418RX Issued in OH

Practice address

575 Copeland Mill Rd Ste 1D
Westerville, OH 43081-8977

Phone

(614) 794-0481

NPI assigned

Jan 25, 2022

Last updated

Jan 25, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in OH

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

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Hospital of Union CountyGroup PAC ID 3577551621, 25 clinicians

Wedgewood Urgent Care, LTDGroup PAC ID 1557266129, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Hospital, Marysville, OH, CCN 360092

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Memorial Hospital of Union County

  dba Memorial Urgent Care

  • Urgent Care Clinic/Center
  • Marysville, OH
  • NPI 1093763757
  Medicare reassignment Care Compare group NPD
• Wedgewood Urgent Care, LTD

  • Family Medicine Physician
  • Powell, OH
  • NPI 1487601167
  Medicare reassignment Care Compare group
• Ohio Emergency Professionals Inc

  • Emergency Medicine Physician
  • Columbus, OH
  • NPI 1982983425
  Medicare reassignment
• Immediate Health Associates

  • Emergency Medicine Physician
  • Westerville, OH
  • NPI 1639123193
  NPD (past)

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

• Memorial Hospital of Union County

  dba Memorial Hospital

  • General Acute Care Hospital
  • Marysville, OH
  • NPI 1720159338
  Care Compare affiliation

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1194477646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 BERRYBUSH DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432305108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 COPELAND MILL RD STE 1D",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818977",
            "telephone_number": "614-794-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "JACKSON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007418RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• LW Care LLC
• Lyle T Olson MD Inc
• Lynn a Monstwil DDS Inc (Westerville Family Dental Care)
• Elizabeth Bernadean Lyons, DMD
• Nancy Lytle
• Catherine Macfarland, BCBA/COBA
• Robert James Macielak, MD
• Latisha Mackey, BCBA
• Shelby Mackey, LSW
• Barbara Mackinaw-Koons, PHD

• Physician Assistant in Westerville, OH
• Providers in Westerville, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.