Jonathon Troy Jackson

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2017-02028 Issued in NC

Practice address

15 Yorkshire St Ste 201
Asheville, NC 28803-7785

Phone

(828) 274-1600

Fax

(828) 274-1603

NPI assigned

Mar 22, 2016

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

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: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jonathon.jackson@233771594350596.direct.elationemr.com

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1366804163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 YORKSHIRE ST STE 201",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288037785",
            "telephone_number": "828-274-1600",
            "fax_number": "828-274-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 YORKSHIRE ST STE 201",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288037785",
            "telephone_number": "828-274-1600",
            "fax_number": "828-274-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JONATHON",
        "middle_name": "TROY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2017-02028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366804163",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deven Jackson
• Eileen Marie Jackson, CADC, CPSS, BS
• Evlyn Elizabeth Jackson, LCSWA
• Gracie Annette Jackson
• Jennifer Cheek Jackson, DMD
• Julie Ann Jackson
• Kimberly Taylor Jackson, M.A., LPA
• Larri Geyneece Jackson
• Laura Jackson, LPCA, LCASA
• Mark T Jackson, M.D.

• Family Medicine Physician in Asheville, NC
• Providers in Asheville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.