Damien Jackson

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

34931 Issued in OK

Practice address

6161 S Yale Ave
Tulsa, OK 74136-1902

Phone

(918) 682-5501

NPI assigned

Apr 6, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, OK, TX3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 50)

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10052317

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.

• Ies ER Oklahoma LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1447148093
  Medicare reassignment NPD
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment NPD
• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment NPD
• Integrative Emergency Services Physician Group-Houston PLLC

  • Emergency Medicine Physician
  • Pasadena, TX
  • NPI 1801458708
  Medicare reassignment NPD
• Jefferson Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Beaumont, TX
  • NPI 1609559699
  Medicare reassignment NPD
• Pomerene Hospital

  • Critical Access Hospital
  • Millersburg, OH
  • NPI 1770957185
  Medicare reassignment NPD
• Round Table Physicians Group PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bellaire, TX
  • NPI 1023439114
  Medicare reassignment NPD
• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment NPD
• Usacs Integrated Acute Care Services of Texas, PLLC

  • Internal Medicine Physician
  • Cedar Park, TX
  • NPI 1801300322
  Medicare reassignment NPD
• Jasper Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Jasper, TX
  • NPI 1346442746
  NPD
• Jefferson Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Beaumont, TX
  • NPI 1497966949
  NPD
• Round Table Specialist Group, PLLC

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1497152268
  NPD

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1275997298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "184-942-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-682-5501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Akron General Ave",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443072432",
            "country_code": "US",
            "telephone_number": "330-344-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DAMIEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "34931",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breyan Lashawn Jackson
• Carl Jackson, PA-C
• Chelcie Dawne Jackson
• Chelsea Ladon Jackson
• Christopher Anthony Jackson
• Dana Lynn Jackson, LADC UNDER SUPER
• Darian J Jackson
• Donnelle Keelyn Jackson
• Douglas Wayne Jackson, DDS
• Ebony Tamu Jackson, CLTC, CHHA, CCNA

• Emergency Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Emergency Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.