Sara Jackson

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

200 Medical Park Blvd
Petersburg, VA 23805-9274

Phone

(804) 765-5000

NPI assigned

Jan 7, 2015

Sex

Female

Sole proprietor

No

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 VA

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

Merit-based Incentive Payment System (MIPS)

Final score

84.24 of 100Reported as group

Quality

75.4

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593

  VA

  Medicare reassignment
• Mep Health, LLC

  • Emergency Medicine Physician
  • Rockville, MD
  • NPI 1164483558

  VA

  Medicare reassignment
• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393
  NPD
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008
  NPD (past)

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1295123602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 ADVANCE MILLS RD",
            "city": "RUCKERSVILLE",
            "state": "VA",
            "postal_code": "229683209",
            "telephone_number": "757-651-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059274",
            "telephone_number": "804-765-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. Houseworth, DPM LLC
• Jackson Professional Serv LLC
• Alexandrea J Jackson, LPC
• Jasmine Shanae Jackson, NP
• Lauran Dekease Jackson
• Valecia Jackson, CSAC
• Rachael Jadidi, FNP
• Iteisha James-Crenshaw, LCSW
• Brianna R Jaris, PSY.D.
• Valerie L Jaskowski, FNP

• Medical Physician Assistant in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.