Kevin Lee Jackson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

6757 Issued in AL

Practice address

2430 Village Professional Dr
Opelika, AL 36801-2378

Phone

(334) 821-6300

Fax

(334) 821-1849

NPI assigned

Nov 4, 2005

Last updated

Jan 26, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in AL

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 1

Specialty

Internal Medicine

Education

University of Alabama School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Homecare of East Alabama Medical Center Home health agency, Auburn, AL, CCN 017129
• Prohealth Home Health Home health agency, Auburn, AL, CCN 017063
• Amedisys Home Health of Opelika Home health agency, Opelika, AL, CCN 017157
• Prime Home Health of Lee County Home health agency, Opelika, AL, CCN 017147
• The East Alabama Healthcare Authority Hospital, Opelika, AL, CCN 010029
• Eamc - Lanier Hospital, Valley, AL, CCN 010780

Merit-based Incentive Payment System (MIPS)

Final score

85.51 of 100Reported as individual

Quality

77.05

Improvement activities

40

Cost

82.29

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• bcbs alabama network 01H0
• bcbs alabama network 01C0
• bcbs alabama network 01E0
• bcbs alabama network 01A0
• bcbs alabama network 01B0
• bcbs alabama network 01G0

Interoperability endpoints

• Direct secure messaging: kevin.jackson@kevjack.direct.medconnect-inc.com
• Direct secure messaging: kevin.jackson@klj.direct.medconnecthealth.com

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

• Amedisys Alabama, LLC

  dba Amedisys Home Health of Opelika

  • Home Health Agency
  • Opelika, AL
  • NPI 1639137011
  Care Compare affiliation
• East Alabama Medical Center Homecare, LLC

  dba Adoration Home Health

  • Home Health Agency
  • Auburn, AL
  • NPI 1770717738
  Care Compare affiliation
• Prime Home Health of Lee County, LLC

  • Home Health Agency
  • Opelika, AL
  • NPI 1013457621
  Care Compare affiliation
• Prohealth Home Health, LLC

  dba ProHealth Home Health

  • Home Health Agency
  • Birmingham, AL
  • NPI 1194324624
  Care Compare affiliation
• The East Alabama Health Care Authority

  dba East Alabama Medical Center

  • General Acute Care Hospital
  • Opelika, AL
  • NPI 1154386431
  Care Compare affiliation
• The East Alabama Health Care Authority

  dba Eamc-Lanier Rural Emergency Hospital

  • General Acute Care Hospital
  • Valley, AL
  • NPI 1780235002
  Care Compare affiliation

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1316938517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 VILLAGE PROFESSIONAL DR",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368012378",
            "telephone_number": "334-821-6300",
            "fax_number": "334-821-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 VILLAGE PROFESSIONAL DR",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368012378",
            "telephone_number": "334-821-6300",
            "fax_number": "334-821-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KEVIN",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "6757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000011573",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Internal Medicine Lab.
• Emily Spain Ireland, DO
• Isi Therapeutic Family Services, LLC
• Emily Jackson, CRNP
• Katie Jackson, PT, DPT
• Omayra Jackson, ALC
• Alexandrea Cool Jager, MD
• James B. Leonard, DMD, LLC
• James P. Hannahan, D.M.D., P.C.
• Ashley Jang, MS, CCC-SLP

• Internal Medicine Physician in Opelika, AL
• Providers in Opelika, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; 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.