Active NPI
John A Jackson, MD
- Psychiatry Physician
- Nashville, TN
National Provider Identifier
1285721324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD36249
- Practice address
- 1310 24TH Ave S
Nashville, TN 37212-2637 - Phone
- (615) 873-6967
- NPI assigned
- Oct 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD36249 | TN | |
| Psychiatry Physician | 2084P0800X | MD36249 | TN | Primary |
Addresses
Primary practice location
1310 24TH Ave S
Nashville, TN 37212-2637
Mailing address
1310 24TH Ave S
Nashville, TN 37212-2637
Phone (615) 218-4426
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD36249 | TN | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1285721324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 24TH AVE S",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372122637",
"telephone_number": "615-218-4426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 24TH AVE S",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372122637",
"telephone_number": "615-873-6967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JOHN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-09",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "TN",
"license": "MD36249",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TN",
"license": "MD36249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.