Elizabeth Marie Jackson, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9103001 Issued in FL

Practice address

515 Wekiva Commons Circle
Apopka, FL 32712

Phone

(407) 464-9516

Fax

(407) 464-9519

NPI assigned

Sep 21, 2006

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

Not listed in the public Medicare enrollment file

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.

Specialty

Physician Assistant

Education

Wayne State University School of Medicine, 2004

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ejackson1133069@direct.hfhs.org

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.

• Central Florida Hospitalist Partners PA

  • Hospitalist Physician
  • Orlando, FL
  • NPI 1558381921
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295834893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 WEKIVA COMMONS CIRCLE",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32712",
            "telephone_number": "407-464-9516",
            "fax_number": "407-464-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 WEKIVA COMMONS CIRCLE",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32712",
            "telephone_number": "407-464-9516",
            "fax_number": "407-464-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jabez Service LLC
• Kristi L Jackley, SPEECH PATHOLOGIST
• Kimberly A Jackman, MA CCC-SLP
• Marissa Jackman
• Ashanti D Jackson
• Elizabeth Marie Jackson, NP
• Saman Jalil, M.D.
• Kerry Jannetta-Dias
• Cesar Antonio Jara, MD
• Nicole Paola Jativa, WHNP-BC

• Medical Physician Assistant in Apopka, FL
• Providers in Apopka, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.