NPIMap

Individual provider Active NPI

Eric Steed Jackson, M.D.

  • Family Medicine Physician
  • Evansville, IN
National Provider Identifier
1245317429
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01047256A Issued in IN
Practice address
1033 E Mount Pleasant Rd
Suite D
Evansville, IN 47725-7149
Phone
(812) 868-0530
Fax
(812) 868-2188
NPI assigned
Nov 1, 2006
Last updated
Dec 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01047256A IN Primary

Addresses

Primary practice location

1033 E Mount Pleasant Rd
Suite D
Evansville, IN 47725-7149

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 868-0530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100802000891 IN Practitioner - Family Practice 5092848713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Owensboro Health, IncGroup PAC ID 0547154650, shared by 9 NPIs, 179 clinicians
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

1006 Ford Ave
Owensboro, KY 42301-4677
Phone (270) 688-4845

1204 Williams St
Oakland City, IN 47660-1001
Phone (812) 749-6187

421 Chestnut St
Evansville, IN 47713-1227
Phone (812) 426-6645

4949 Healthy Way
Suite a
Evansville, IN 47715-1180
Phone (812) 868-0530

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc Family Medicine CurrentSince Dec 15, 2014 Accepting new patients
Deaconess Clinic, Inc. Family Medicine CurrentSince Dec 15, 2014 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Major Hospital Past Accepting new patients
Deaconess Hospital, Inc Family Medicine Past Accepting new patients

Locations

1033 E Mount Pleasant Rd
Ste D
Evansville, IN 47725
Phone (812) 868-0530

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4949 Healthy Way
Ste A
Evansville, IN 47715
Phone (812) 868-0530

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Interoperability endpoints

  • Direct secure messaging: ejackson25706@direct.deaconess.com

Organizations & group practices 5

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1245317429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-868-0530",
            "fax_number": "812-868-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 E MOUNT PLEASANT RD",
            "address_2": "SUITE D",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477257149",
            "telephone_number": "812-868-0530",
            "fax_number": "812-868-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ERIC",
        "middle_name": "STEED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01047256A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.