John T Jackson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA00132 Issued in RI

Practice address

11 Friendship St
Newport, RI 02840-2271

Phone

(401) 845-1593

Fax

(401) 847-0650

NPI assigned

Apr 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

96.45 of 100Reported as group

Quality

85.46

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239321600000",
    "number": "1295792687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 FRIENDSHIP ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402271",
            "telephone_number": "401-845-1593",
            "fax_number": "401-847-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FRIENDSHIP ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402271",
            "telephone_number": "401-845-1593",
            "fax_number": "401-847-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOHN",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2009-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "RI",
            "license": "PA00132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7006480",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simisola Imonah
• Informed Pregnancy and Birth Collective LLC
• Benjamin James Ingram, M.D.
• Kenneth Jay Iverson, MD
• Heather L Jackson
• Stacey Lynn Jacobs, DMD
• James L Maher Center
• James L Maher Center
• James L Maher Center
• James L Maher Center

• Medical Physician Assistant in Newport, RI
• Providers in Newport, RI by specialty
• Medical Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2009; 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.