Miles Jackson, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

4301508401 Issued in MI

Practice address

300 W Washington Ave Ste 300
Jackson, MI 49201-2160

Phone

(517) 205-1305

Fax

(313) 876-1305

NPI assigned

Aug 14, 2015

Last updated

Dec 16, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjackson833272@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  NPD
• W. a. Foote Memorial Hospital

  dba Allegiance Health

  • Internal Medicine Physician
  • Jackson, MI
  • NPI 1760437826
  NPD
• W.a. Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  NPD (past)

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1336515295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W WASHINGTON AVE STE 300",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012160",
            "telephone_number": "517-205-1305",
            "fax_number": "313-876-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MILES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-14",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301508401",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301508401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Jackson
• Laquita Jackson, LLBSW
• Lesley Tyesha Jackson, FNP
• Mercedes Jackson
• Michael Timothy Jackson Sr., BSW
• Ronald Duane Jackson, MALLPC
• Emily Renee Jacob
• Angela Jacobs, CNP
• Kevin F Jager, PA-C
• Nitin Jain

• Vascular Surgery Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Vascular Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.