Jackson Laboue, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110007683 Issued in VA

Practice address

5899 Bremo Rd Ste 100
Richmond, VA 23226-1935

Phone

(804) 288-8512

Fax

(804) 288-4552

NPI assigned

Oct 6, 2020

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 VA

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthovirginia IncGroup PAC ID 0547157224, 570 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CJW Medical Center Hospital, Richmond, VA, CCN 490112

Merit-based Incentive Payment System (MIPS)

Final score

90.85 of 100Reported as group

Quality

90.74

Promoting interoperability

100

Improvement activities

40

Cost

78.74

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jlaboue29630@direct.orthovirginia.com

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.

• Orthovirginia Inc

  • Multi-Specialty Clinic/Center
  • Mechanicsville, VA
  • NPI 1487671822
  Medicare reassignment Care Compare group
• Orthovirginia, Inc

  • Physical Medicine & Rehabilitation Physician
  • Arlington, VA
  • NPI 1376411413
  NPD
• Orthovirginia, Inc.

  • Multi-Specialty Clinic/Center
  • Forest, VA
  • NPI 1649748526

  Physician Assistant

  NPD
• Orthovirginia, Inc.

  • Multi-Specialty Clinic/Center
  • North Chesterfield, VA
  • NPI 1265470645
  NPD (past)

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

• Chippenham & Johnston-Willis Hospitals Inc

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1598708513
  Care Compare affiliation

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1205433885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BOULDERS PKWY STE 200",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232254067",
            "telephone_number": "804-560-5595",
            "fax_number": "804-560-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5899 BREMO RD STE 100",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261935",
            "telephone_number": "804-288-8512",
            "fax_number": "804-288-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABOUE",
        "first_name": "JACKSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-06",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Labarre, LMHC
• Laboratory Corporation of America Holdings
• Laboratory Corporation of America Holdings
• Laboratory Corporation of America Holdings
• Laboratory Corporation of America Holdings
• Diana Andreea Lacatusu, DO
• Russell W. Lacey, MD
• Fanny Lachapelle Nilsson
• Christina Lack, FNP-C
• Nina Consalvi Lackey, LPC, CSAC

• Physician Assistant in Richmond, VA
• Providers in Richmond, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.