Leon S Jackson, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

11348 Issued in NV

Practice address

118 E Haskell St
Winnemucca, NV 89445-3247

Phone

(608) 788-8103

Fax

(608) 788-8799

NPI assigned

Oct 13, 2005

Last updated

Jul 24, 2015By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV, CA2 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 2

Specialty

Diagnostic Radiology

Education

University of Utah School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plumas District HospitalGroup PAC ID 8224930466, 40 clinicians

Humboldt General HospitalGroup PAC ID 5193709798, shared by 5 NPIs, 41 clinicians

Banner HealthGroup PAC ID 9537078365, shared by 11 NPIs, 21 clinicians

Eastern Plumas Health Care DistrictGroup PAC ID 4587576889, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Lassen Medical Center Hospital, Susanville, CA, CCN 051320
• Humboldt General Hospital Hospital, Winnemucca, NV, CCN 291308
• Eastern Plumas Hospital - Portola Campus Hospital, Portola, CA, CCN 051300

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Eastern Plumas Health Care District

  • Critical Access Hospital
  • Portola, CA
  • NPI 1245236850
  Medicare reassignment Care Compare group NPD
• Plumas District Hospital

  • Critical Access Hospital
  • Quincy, CA
  • NPI 1326094269
  Medicare reassignment Care Compare group NPD
• Humboldt General Hospital

  • Critical Access Hospital
  • Winnemucca, NV
  • NPI 1750498010
  Medicare reassignment NPD
• Humboldt General Hospital

  • Adult Medicine Physician
  • Winnemucca, NV
  • NPI 1922152784
  Medicare reassignment NPD
• Northstar Radiology

  • Diagnostic Radiology Physician
  • Winnemucca, NV
  • NPI 1356768014
  Medicare reassignment NPD
• Sparks Radiology Group LTD.

  • Diagnostic Radiology Physician
  • Sparks, NV
  • NPI 1992919237
  Medicare reassignment NPD
• William Bee Ririe Hospital

  • Critical Access Hospital
  • Ely, NV
  • NPI 1487648804
  Medicare reassignment NPD
• Banner Health

  • Radiology Clinic/Center
  • Susanville, CA
  • NPI 1427740570

  NV

  Medicare reassignment NPD
• Eastern Plumas Health Care District

  dba Eastern Plumas Health Care

  • Critical Access Hospital
  • Portola, CA
  • NPI 1326044140
  Medicare reassignment
• Humboldt General Hospital

  • Land Ambulance
  • Winnemucca, NV
  • NPI 1699899229
  NPD
• William Bee Ririe Hospital

  • Family Nurse Practitioner
  • Crescent Valley, NV
  • NPI 1699284901

  Family Medicine

  NPD
• William Bee Ririe Retail Pharmacy

  • Community/Retail Pharmacy
  • Ely, NV
  • NPI 1831729268
  NPD

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

• Humboldt General Hospital

  • Critical Access Hospital
  • Winnemucca, NV
  • NPI 1750498010
  Care Compare affiliation
• Banner Lassen Medical Center

  • Critical Access Hospital
  • Susanville, CA
  • NPI 1538197231
  Care Compare affiliation
• Eastern Plumas Health Care District

  dba Eastern Plumas Health Care

  • Critical Access Hospital
  • Portola, CA
  • NPI 1326044140
  Care Compare affiliation
• Eastern Plumas Health Care District

  dba Eastern Plumas Health Care

  • Critical Access Hospital
  • Portola, CA
  • NPI 1982600920
  Care Compare affiliation

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1285622175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 32ND ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546017099",
            "telephone_number": "608-788-8103",
            "fax_number": "608-788-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E HASKELL ST",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894453247",
            "telephone_number": "608-788-8103",
            "fax_number": "608-788-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LEON",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "11348",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G68430",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100505784",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Humboldt Human Development SVS
• Humboldt Physcial Therapy & Fitness
• Humboldt Shredders Inc
• Stephanie Huseboe, AEMT
• Justin Irvin, EMT-P
• Jade Nobe Clinic-JHMC, LLC (Jade House Managed Care)
• Susan Louise Jancar, DDS
• Dacey Jensen, DPT
• Janita Jensen, LCSW
• Margaret Humphrey Johnson, R.D.

• Diagnostic Radiology Physician in Winnemucca, NV
• Providers in Winnemucca, NV by specialty
• Diagnostic Radiology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.