Active NPI
Howard B Jackson, MD
- Interventional Pain Medicine Physician
- Temple Terrace, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- License
- ME79194
- 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, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 250011193 | Other | FL | RAILROAD MEDICARE |
| 5320656 | Other | FL | AETNA |
| 8294118 | Other | FL | CIGNA |
| 258188400 | Medicaid | FL | |
| 270565 | Other | FL | AVMED |
| 49333 | Other | FL | BLUE 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Pain Management
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| ME79194 | FL | MD | Interventional Pain Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tallahassee Orthopedic Clinic III PL | Interventional Pain Medicine | Current | Accepting new patients |
| Musculoskeletal Institute Chartered | Current | Accepting new patients | |
| Tallahassee Orthopedic Clinic III, P.L. | Current | Accepting new patients | |
| Musculoskeletal Institute Chartered | Current | 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
- 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.
-
dba Tallahassee Orthopedic Clinic
- Medical Specialty Clinic/Center
- Tallahassee, FL
- NPI 1194778050
Interventional Pain Medicine
-
dba Florida Orthopaedic Institute
- Orthopaedic Surgery Physician
- Temple Terrace, FL
- NPI 1386639920
-
- Orthopaedic Surgery Physician
- Trinity, FL
- NPI 1508499302
-
- Durable Medical Equipment & Medical Supplies
- Panama City Beach, FL
- NPI 1497617948
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Enhabit Home Health
- Home Health Agency
- Tampa, FL
- NPI 1558777102
-
dba AdventHealth North Pinellas
- General Acute Care Hospital
- Tarpon Springs, FL
- NPI 1568473015
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.