James Mark Jackson, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

31633 Issued in KY

Practice address

501 S 2ND St
Louisville, KY 40202-1864

Phone

(502) 583-7546

Fax

(502) 589-3429

NPI assigned

Jun 9, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Mark Jackson Other name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dermatology

Education

Texas a & M University System, HSC, College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.jackson@forefrontdermatology.emadirect.md

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Louisville, KY
  • NPI 1861897217

  Dermatology, KY

  Medicare reassignment NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Seymour, IN
  • NPI 1659796225

  Dermatology, IN

  Medicare reassignment NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Louisville, KY
  • NPI 1629524913

  Dermatology

  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385

  Dermatology

  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Jeffersonville, IN
  • NPI 1780137232

  Dermatology

  NPD
• University Medical Associates

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1417902925
  NPD (past)
• University Physicians Group - Radiology

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1619061116
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1205830007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "866-630-9882",
            "fax_number": "920-682-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 2ND ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021864",
            "telephone_number": "502-583-7546",
            "fax_number": "502-589-3429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "265 Quartermaster Ct",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471303669",
            "country_code": "US",
            "telephone_number": "812-932-2387",
            "fax_number": "812-284-0159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JAMES",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01085873A",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "J8602",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "31633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mark.Jackson@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "265 Quartermaster Ct",
            "city": "Jeffersonville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471303669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mark.Jackson@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "501 S 2nd St",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "JACKSON",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Erica Jackson
• Erica T Jackson
• Ethan Jackson, PHARMD
• Jade Jackson, RBT
• James D Jackson, MD
• James W Jackson Jr., MD
• Jamie Kay Jackson
• Jasen Jackson
• Jeffrey N Jackson, PSYCHOLOGIST
• Jill Marie Jackson, RN

• All providers in Louisville, KY
• Dermatology Physician in Kentucky

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