John Owens Jackson Jr., MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD14033 Issued in TN

Practice address

1323 East Wood Street
East Wood Clinic
Paris, TN 38242

Phone

(731) 642-2011

Fax

(731) 644-2758

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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: 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

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1386676534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 EAST WOOD STREET",
            "address_2": "EAST WOOD CLINIC",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "38242",
            "telephone_number": "731-642-2011",
            "fax_number": "731-644-2758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 EAST WOOD STREET",
            "address_2": "EAST WOOD CLINIC",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "38242",
            "telephone_number": "731-642-2011",
            "fax_number": "731-644-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOHN",
        "middle_name": "OWENS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD14033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000296",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen M Hughes, LCSW
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• Suzanne Jackson
• McKenzie Jacobson, PA
• JDM Blessings LLC
• Jeffrey B. Warren, M.D. and Associates, P.C.
• Deborah Jelks, DPT

• Pediatrics Physician in Paris, TN
• Providers in Paris, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.