NPIMap

Individual provider Active NPI

Anthony Kory Jackson, MD

  • Family Medicine Physician
  • Hutchinson, KS
National Provider Identifier
1366413114
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-30714 Issued in KS
Practice address
2101 N Waldron St
Hutchinson, KS 67502-1131
Phone
(620) 669-2500
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-30714 KS Primary

Addresses

Primary practice location

2101 N Waldron St
Hutchinson, KS 67502-1131

Mailing address

2101 N Waldron St
Hutchinson, KS 67502-1197
Phone (620) 669-2500

Other identifiers 1

IdentifierTypeStateIssuer
200260300 AMedicaidKS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address anthonyjackson@hcpa.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825000474 KS Practitioner - Family Practice 2365416278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Emory University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center, P.a.Group PAC ID 3971408642, 25 clinicians
Hutchinson Clinic PA IncGroup PAC ID 5597658492, 130 clinicians

Practice addresses (Care Compare)

1100 N Main St
Hutchinson, KS 67501-4406

2101 N Waldron St
Hutchinson, KS 67502-1131
Phone (620) 669-2500

Hospital & facility affiliations

  • Angels Care Home Health Home health agency, Wichita, KS, CCN 178088
  • Hospice and Homecare of Reno County Home health agency, Hutchinson, KS, CCN 177127
  • Gentiva Hospice, Wichita, KS, CCN 171542
  • Hospice and Homecare of Reno County Hospice, Hutchinson, KS, CCN 171503
  • Kansas City Hospice and Palliative Care Hospice, Kansas City, MO, CCN 261503
  • Hutchinson Regional Medical Center Inc Hospital, Hutchinson, KS, CCN 170020
  • Saint Luke'S South Hospital Hospital, Overland Park, KS, CCN 170185
  • Summit Surgical, LLC Hospital, Hutchinson, KS, CCN 170198
  • St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138
  • McPherson Hospital Hospital, McPherson, KS, CCN 170105
  • Buhler Sunshine Home Nursing home, Buhler, KS, CCN 175404
  • Mennonite Friendship Communities Inc Nursing home, South Hutchinson, KS, CCN 175379

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-30714KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Clinic, P.a., Inc. CurrentSince Aug 2, 2004 Accepting new patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients
Heartland Radiation Oncology Current Accepting new patients
Hutchinson Clinic, P.a. Inc. Current Accepting new patients
Hutchinson Clinic, PA, Inc. CurrentSince Aug 2, 2004 Accepting new patients

Locations

2101 N Waldron St
Hutchinson, KS 67502
Phone (620) 669-2500

Interoperability endpoints

  • Direct secure messaging: anthonyjackson@hcpa.allscriptsdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1366413114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N WALDRON ST",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021197",
            "telephone_number": "620-669-2500",
            "fax_number": "620-669-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WALDRON ST",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021131",
            "telephone_number": "620-669-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANTHONY",
        "middle_name": "KORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-30714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200260300 A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anthonyjackson@hcpa.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "HUTCHINSON CLINIC, PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2101 N Waldron St",
            "city": "Hutchinson",
            "state": "KS",
            "country_code": "US",
            "postal_code": "675021131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hutchinson, KS

Sources for this page

Verify at the official NPI Registry.