Wesley Matthew Jackson, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

207903 Issued in NC

Practice address

5801 Mountain Island Dr
Durham, NC 27713-8909

Phone

(817) 428-2404

NPI assigned

Apr 24, 2012

Last updated

Jan 6, 2018By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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 Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wjackson127332@direct.unc.nchie.net

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.

• University of North Carolina at Chapel Hill

  dba UNC Faculty Physicians

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200
  Medicare reassignment NPD
• Park Ophthalmology

  • Ophthalmology Physician
  • Durham, NC
  • NPI 1619150141
  NPD (past)

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515196800000",
    "number": "1225396690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 MOUNTAIN ISLAND DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277138909",
            "telephone_number": "817-428-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 MOUNTAIN ISLAND DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277138909",
            "telephone_number": "817-428-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "WESLEY",
        "middle_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-24",
        "last_updated": "2018-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NC",
            "license": "207903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael N.S Jackson
• Shannon Laura Jackson, RN
• Sharhonda Jackson, RN
• Sheena S Jackson, RD
• Susanne Socha Jackson
• William Jackson, DPT
• Sara Dawn Jacob
• Jacob's Ladder Speech and Language, PLLC
• Peter De Greeff Jacobi, M.D.
• Ashley Taylor Jacobs, IBCLC

• Neonatal-Perinatal Medicine Physician in Durham, NC
• Providers in Durham, NC by specialty
• Neonatal-Perinatal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2018; 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.