Jackson Primary Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

50448 Issued in TN

Legal business name

JACKSON PRIMARY CARE

Practice address

2010 Church St Ste 526
Nashville, TN 37203

Phone

(615) 329-7969

NPI assigned

Mar 26, 2018

Last updated

Aug 1, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Eric Jackson, MD

Title

Ceo

Phone

(615) 423-3276

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sheila Peters, PHD

  • Psychologist
  • Nashville, TN
  • NPI 1861998395

  Single Specialty

  NPD

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533081600000",
    "number": "1235634023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 CHURCH ST STE 526",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032026",
            "telephone_number": "615-329-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 CHURCH ST STE 526",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37203",
            "telephone_number": "615-329-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-26",
        "last_updated": "2018-08-01",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-423-3276",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "50448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q020871",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackie-D-Yak, LLC
• Jackson Anesthesia Services PC
• Jackson Health Care LLC
• Jackson Homecare Ministries 1 (Jackson HomeCare Ministries 2)
• Jackson Park Christian Home, Inc.
• Carolyn Denise Jackson-Gardner, FNP-C
• Alan Jackson, DPT
• Alisha Evon Jackson, BCBA, LBA
• Amara N Jackson
• Amy E Jackson

• Family Medicine Physician in Nashville, TN
• Providers in Nashville, 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 Aug 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.