Kathy M Jackson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101013273 Issued in MI

Practice address

502 W Central Ave
La Follette, TN 37766-3400

Phone

(423) 562-1705

NPI assigned

Jun 16, 2006

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

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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.

• Albuquerque Indian Health Center

  • Clinic/Center
  • Albuquerque, NM
  • NPI 1659458917

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215971379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 111",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637020111",
            "telephone_number": "423-562-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W CENTRAL AVE",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377663400",
            "telephone_number": "423-562-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KATHY",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• IHS Acquisition Xxvii Inc (American Oxygen Home Care)
• Internal and Pulmonary Medicine of Lafollette, PC
• Ray Howe Irwin Jr.
• Jamal Isber, M.D.
• Jeremiah Lee Jackson
• Roger Jackson
• Emily C James, SPEECH PATHOLOGIST
• Chandler Jones, RRT
• Jamie M. Jones, BSN, RN
• Macy Reed Jones, OT

• Family Medicine Physician in La Follette, TN
• Providers in La Follette, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.