Chad Michael Jackson, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

41238 Issued in TN

Practice address

1747 Medical Center Pkwy
Suite 210
Murfreesboro, TN 37129-2563

Phone

(615) 893-1600

Fax

(615) 225-6887

NPI assigned

Jul 10, 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

Medicare fee-for-service enrollment

Enrolled in TN

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

Urology

Education

Louisiana State University School of Medicine in New Orleans, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Middle Tennessee Urology Specialists PLLCGroup PAC ID 3476654518, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Thomas Rutherford Hospital Hospital, Murfreesboro, TN, CCN 440053
• Saint Thomas River Park Hospital Hospital, McMinnville, TN, CCN 440151

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chadjackson@mtus.medalliesdirect.net

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.

• Middle Tennessee Urology Specialists PLLC

  • Urology Physician
  • Murfreesboro, TN
  • NPI 1194944660
  Medicare reassignment Care Compare group NPD

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

• Saint Thomas River Park Hospital, LLC

  • General Acute Care Hospital
  • McMinnville, TN
  • NPI 1518346469
  Care Compare affiliation
• Saint Thomas River Park Hospital, LLC

  • Ambulatory Surgical Clinic/Center
  • McMinnville, TN
  • NPI 1558742304

  Hospital

  Care Compare affiliation
• Saint Thomas Rutherford Hospital

  • General Acute Care Hospital
  • Murfreesboro, TN
  • NPI 1164590386
  Care Compare affiliation

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1386678191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 MEDICAL CENTER PKWY",
            "address_2": "SUITE 210",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292563",
            "telephone_number": "615-893-1600",
            "fax_number": "615-225-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 MEDICAL CENTER PKWY",
            "address_2": "SUITE 210",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292563",
            "telephone_number": "615-893-1600",
            "fax_number": "615-225-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHAD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "41238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Jackson Phothirath
• Aija Brianna Jackson
• Barbara G Jackson, RN
• Bruce Jackson Jr.
• Cathaleen Jackson, OTR
• Christina Jackson, LPC-MHSP
• Elizabeth Galland Jackson, M.D.
• Jeffrey Brett Jackson, PHARMD,BSPHARMSCI,BS
• Joseph Jackson, DC
• Kelly Amanda Jackson, APRN

• Specialist in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.