Active NPI
Gina Diane Jackson, PA-C
- Physician Assistant
- Alexandria, VA
National Provider Identifier
1265785786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110-004038
- Practice address
- 8109 Tis Well Drive
Suite 511
Alexandria, VA 22306 - Phone
- (703) 799-9500
- Fax
- (703) 799-9502
- NPI assigned
- Oct 22, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110-004038 | VA | Primary |
Addresses
Primary practice location
8109 Tis Well Drive
Suite 511
Alexandria, VA 22306
Mailing address
8109 Tis Well Drive
Suite 511
Alexandria, VA 22306
Phone (703) 799-9500
Other practice location 1
9300 DeWitt Loop
Oaks Pavilion, Floor 2, Room O2.300
Fort Belvoir, VA 22060-5285
Phone (571) 231-4495
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gjackson157447@soc.inova.org | Health Information Exchange (HIE) | Inova Physician Partners, LLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Legacy Healthcare Services Inc
Practice addresses (Care Compare)
3914 Centreville Rd
Suite 250
Chantilly, VA 20151-3290
Phone (703) 435-1223
8109 Tis Well Dr
Suite 511
Alexandria, VA 22306-3211
Phone (703) 799-9500
9642 Burke Lake Rd
Burke, VA 22015-3052
Phone (703) 543-7920
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.98 of 100
- Quality
- 87.97
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110-004038 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inova Physician Partners, Inc. - Specialists | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Leesburg, VA
- NPI 1811204050
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Inova Alexandria Hospital
- General Acute Care Hospital
- Alexandria, VA
- NPI 1255684460
-
dba Inova Mount Vernon Hospital
- General Acute Care Hospital
- Alexandria, VA
- NPI 1922139120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625702400000",
"number": "1265785786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8109 TIS WELL DRIVE",
"address_2": "SUITE 511",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "22306",
"telephone_number": "703-799-9500",
"fax_number": "703-799-9502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8109 TIS WELL DRIVE",
"address_2": "SUITE 511",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "22306",
"telephone_number": "703-799-9500",
"fax_number": "703-799-9502"
}
],
"practiceLocations": [
{
"address_1": "9300 DeWitt Loop",
"address_2": "Oaks Pavilion, Floor 2, Room O2.300",
"address_purpose": "LOCATION",
"city": "Fort Belvoir",
"state": "VA",
"postal_code": "220605285",
"country_code": "US",
"telephone_number": "571-231-4495",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "GINA",
"middle_name": "DIANE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-22",
"last_updated": "2021-07-08",
"certification_date": "2021-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110-004038",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gjackson157447@soc.inova.org",
"affiliation": "Y",
"endpointDescription": "Health Information Exchange",
"affiliationName": "Inova Physician Partners, LLC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "8109 Tis Well Dr",
"address_2": "Suite 511",
"city": "Alexandria",
"state": "VA",
"country_code": "US",
"postal_code": "22306",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.