Jackson Son

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024189383 Issued in VA

Practice address

5039 Americana Dr
Annandale, VA 22003-5068

Phone

(571) 524-0881

NPI assigned

Mar 13, 2024

Last updated

Nov 19, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jackson Son Other name

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ennoble HC DMV LLCGroup PAC ID 9032517925, 112 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ennoble HC DMV LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Fulton, MD
  • NPI 1104492115

  DC, VA

  Medicare reassignment Care Compare group NPD
• Ennoble HC DMV II LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Silver Spring, MD
  • NPI 1134002900

  DC, VA

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  VA

  Medicare reassignment NPD
• Lotus Home Health Care LLC

  • In Home Supportive Care Agency
  • Annandale, VA
  • NPI 1093697682
  NPD Authorized official
• Ennoble HC DMV III LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Silver Spring, MD
  • NPI 1922981695

  DC, VA

  Medicare reassignment
• QND Primary Care & Urgent Care LLC

  • Family Medicine Physician
  • Springfield, VA
  • NPI 1588470231
  NPD
• Hirt Family Corp.

  dba Medi-Weightloss

  • Obesity Medicine (Preventive Medicine) Physician
  • Alexandria, VA
  • NPI 1710553482
  NPD (past)

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1265291272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5039 AMERICANA DR",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220035068",
            "telephone_number": "571-524-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5039 AMERICANA DR",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220035068",
            "telephone_number": "571-524-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SON",
        "first_name": "JACKSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-13",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024189383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKSON",
            "last_name": "SON",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Valerie Schnibbe Smith, MSW
• Warren J Smith, D.O.
• Gerald Smolen, LCSW-C
• Sandra E. Sohns, CFNP
• Makar Adel Soliman, DPT
• Minkyeong Son, DPT
• Han D Song
• Sop Song, O.D.
• Lena Soni
• Pooja Soni

• Family Nurse Practitioner in Annandale, VA
• Providers in Annandale, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; 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.

Verify at the official NPI Registry.