Individual provider Active NPI

Howard B Jackson, MD

  • Interventional Pain Medicine Physician
  • Temple Terrace, FL
National Provider Identifier
1255338042
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME79194 Issued in FL
Practice address
13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone
(813) 978-9700
Fax
(813) 558-6134
NPI assigned
Jul 7, 2005
Last updated
Oct 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME79194 FL
Interventional Pain Medicine Physician 208VP0014X ME79194 FL Primary

Addresses

Primary practice location

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925

Mailing address

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone (813) 978-9700

Other identifiers 6

IdentifierTypeStateIssuer
250011193OtherFLRAILROAD MEDICARE
5320656OtherFLAETNA
8294118OtherFLCIGNA
258188400MedicaidFL
270565OtherFLAVMED
49333OtherFLBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20091113000432 FL Practitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 6002954914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Hahnemann University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5901 E Fowler Ave
Suite 100
Temple Terrace, FL 33617-2305
Phone (813) 978-9700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME79194FLMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Orthopedic Clinic III PL Interventional Pain Medicine CurrentSince Sep 11, 2024 Accepting new patients
Musculoskeletal Institute Chartered Current Accepting new patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Sep 11, 2024 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Mar 9, 2021 Accepting new patients

Locations

2605 Welaunee Blvd
Tallahassee, FL 32308
Phone (850) 219-1932

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808

909 N Dale Mabry Hwy
Tampa, FL 33609
Phone (813) 287-9370

909 N Dale Mabry Hwy
Fl Orthopaedic
Tampa, FL 33609

13020 N Telecom Pkwy
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

5901 E Fowler Ave
Ste 100
Temple Terrace, FL 33617
Phone (813) 987-9700

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: howard.jackson.1@18802.direct.athenahealth.com

Organizations & group practices 4

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 2

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1255338042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370925",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370925",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HOWARD",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME79194",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME79194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "250011193",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5320656",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8294118",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258188400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "270565",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "49333",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.