NPIMap

Individual provider Active NPI

Sherri Taylor Jackson, MD

  • Internal Medicine Physician
  • Richmond, VA
National Provider Identifier
1235346495
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101242513 Issued in VA
Practice address
2200 Pump Rd
Suite 200
Richmond, VA 23233-3539
Phone
(804) 741-7141
Fax
(804) 741-6082
NPI assigned
May 17, 2007
Last updated
May 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101242513 VA Primary

Addresses

Primary practice location

2200 Pump Rd
Suite 200
Richmond, VA 23233-3539

Mailing address

2200 Pump Rd
Suite 200
Richmond, VA 23233-3539
Phone (804) 741-7141

Other identifiers 4

IdentifierTypeStateIssuer
C06695OtherVAGROUP PTAN
C09633OtherVAGROUP PTAN
C05704OtherVAGROUP PTAN
C06115OtherVAGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081107000558 VA Practitioner - Internal Medicine 5991864761 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101242513VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Primary Care CurrentSince Jun 8, 2015 Accepting new patients
Bon Secours St. Francis Medical Center LLC Internal Medicine Past Accepting new patients
Bon Secours St Francis Medical Center LLC Past Accepting new patients
Bon Secours Memorial Regional Medical Center Past Accepting new patients
Bon Secours St. Francis Medical Center Inc Past Accepting new patients
Bon Secours Memorial Regional Medical Center Inc Internal Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Harness Health Pharmacy - Central Pharmacy Services LLC Past Accepting new patients
MCV Associated Physicians PastSince Sep 28, 2021 Accepting new patients
Bon Secours St. Francis Medical Center Inc Past Accepting new patients

Locations

7140 Hull Street Rd
Ste 101
North Chesterfield, VA 23235
Phone (804) 276-4141

1800 Glenside Dr
Ste 105
Richmond, VA 23226
Phone (804) 288-0399

2200 Pump Rd
Ste 100
Richmond, VA 23233
Phone (804) 741-7141

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1235346495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PUMP RD",
            "address_2": "SUITE 200",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232333539",
            "telephone_number": "804-741-7141",
            "fax_number": "804-741-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PUMP RD",
            "address_2": "SUITE 200",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232333539",
            "telephone_number": "804-741-7141",
            "fax_number": "804-741-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHERRI",
        "middle_name": "TAYLOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101242513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06695",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C09633",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C05704",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06115",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.