Mark Jackson, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA290 Issued in KY

Practice address

911 Bypass Rd BLDG a
Pikeville, KY 41501-1689

Phone

(606) 430-2206

Fax

(606) 218-7506

NPI assigned

Jan 11, 2006

Last updated

Jun 8, 2022By the provider in NPPES

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

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

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

University of Kentucky College of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Dominion Health and Fitness, IncGroup PAC ID 3274570908, 71 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pikeville Medical Center Hospital, Pikeville, KY, CCN 180044
• Tug Valley Arh Regional Medical Center Hospital, South Williamson, KY, CCN 180069
• Hazard Arh Regional Medical Center Hospital, Hazard, KY, CCN 180029

Merit-based Incentive Payment System (MIPS)

Final score

92.67 of 100Reported as group

Quality

81.47

Promoting interoperability

100

Improvement activities

40

Cost

81.83

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjackson21930@pikevillekydirect.org

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.

• Pikeville Medical Center Inc.

  • Multi-Specialty Clinic/Center
  • Pikeville, KY
  • NPI 1528195864

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Dominion Health & Fitness, Inc

  • Physical Therapist
  • Clintwood, VA
  • NPI 1871513788
  Care Compare group
• Pikeville Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Cheyenne, WY
  • NPI 1891599502
  NPD
• Our Lady of the Way Hospital, Inc

  • Family Medicine Physician
  • Martin, KY
  • NPI 1255357364
  NPD (past)
• Pikeville Medical Center Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Whitesburg, KY
  • NPI 1871575498
  NPD (past)
• Team Radiology Physicians, PA

  • Diagnostic Radiology Physician
  • Knoxville, TN
  • NPI 1932133675
  NPD (past)

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

• Appalachian Regional Healthcare, Inc.

  dba Arh Hazard Family Health Services

  • Multi-Specialty Clinic/Center
  • Hazard, KY
  • NPI 1558431346

  Hospital

  Care Compare affiliation
• Appalachian Regional Healthcare, Inc.

  dba Hazard ARH Regional Medical Center

  • General Acute Care Hospital
  • Hazard, KY
  • NPI 1609869916
  Care Compare affiliation
• Appalachian Regional Healthcare, Inc.

  dba Tug Valley ARH Regional Medical Center

  • General Acute Care Hospital
  • South Williamson, KY
  • NPI 1649270257
  Care Compare affiliation
• Pikeville Medical Center Inc

  • General Acute Care Hospital
  • Pikeville, KY
  • NPI 1285621623
  Care Compare affiliation

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1205815982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415020432",
            "telephone_number": "606-430-2206",
            "fax_number": "606-218-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 BYPASS RD BLDG A",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011689",
            "telephone_number": "606-430-2206",
            "fax_number": "606-218-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARK",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000521209",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00164787",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95002903",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00363176",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjackson21930@PIKEVILLEKYDIRECT.ORG",
            "affiliation": "N",
            "endpointDescription": "direct address for ccda",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "standard direct functionality",
            "address_1": "911 Bypass Rd Bldg A",
            "city": "Pikeville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "415011689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Albert Ison, FNP
• J & J Diagnostics
• J S Osborne OD PSC (J Shane Osborne OD)
• J. Kendall Cecil (East Kentucky Eyecare)
• Johnnie Mac Jackson, MSW, CSW
• Gabriel Jacobs, M.D.
• Brett E Jarrell, MD
• Leigh Jarrell
• Jason N Stamper DO PLLC
• Damien M Jensen, MD

• Physician Assistant in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.