Paul Anthony Jackson Jr.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

31473 Issued in TN

Practice address

529 Brandies Cir
Murfreesboro, TN 37128-0710

Phone

(615) 797-8573

Fax

(423) 567-8573

NPI assigned

Apr 2, 2022

Last updated

Oct 11, 2023By 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

Medicare fee-for-service enrollment

Enrolled in TN

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coffee County Hospital Group IncGroup PAC ID 1456317783, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adoration Home Health, LLC Home health agency, Madison, TN, CCN 447581

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: paul.jackson.1@29160.direct.athenahealth.com
• Direct secure messaging: paul.jackson.1@29901.direct.athenahealth.com

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.

• Beating Pulse LLC

  • Family Medicine Physician
  • Murfreesboro, TN
  • NPI 1194417022
  Medicare reassignment NPD Authorized official
• Coffee Medical Group LLC

  dba Center for Family Medicine

  • Rural Health Clinic/Center
  • Manchester, TN
  • NPI 1700192028
  Care Compare group
• Coffee Medical Group LLC

  dba Unity Medical Center

  • Rural Acute Care Hospital
  • Manchester, TN
  • NPI 1013969179
  NPD (past)
• Coffee Medical Group LLC

  dba Manchester Rural Health Clinic

  • Rural Health Clinic/Center
  • Manchester, TN
  • NPI 1043537046
  NPD (past)
• Geriatric Consulting Group PC

  dba Miller Health Group

  • Specialist
  • Hendersonville, TN
  • NPI 1972511665
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adoration Home Health, LLC

  dba Adoration Home Health

  • Home Health Agency
  • Madison, TN
  • NPI 1790161321
  Care Compare affiliation

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

{
    "created_epoch": "1648857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1285375543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 CAVENDISH DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371282732",
            "telephone_number": "615-542-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 BRANDIES CIR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371280710",
            "telephone_number": "615-797-8573",
            "fax_number": "423-567-8573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "PAUL",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-02",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Jackson, RBT
• Marilyn Moran Jackson, DC
• Morgan F Jackson, MD
• Myrvienne Jackson, FNP
• Paul A Jackson, M.D.
• Rachelle Moriah Jackson, O.D.
• Shonta Monique Jackson
• Tamba Jackson
• Torria Jackson, APRN
• Krysten Alexandra Jacobs, DC, BSC HK

• Family Nurse Practitioner in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.