Active NPI
Joshuah Duncan Jackson, M.D.
- Psychiatry Physician
- Staunton, VA
National Provider Identifier
1407205834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0101269643
- Practice address
- 103 Valley Center Dr
Staunton, VA 24401-5080 - Phone
- (540) 332-8000
- NPI assigned
- Jun 7, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | LL39434 | SC | |
| Psychiatry Physician | 2084P0800X | 0101269643 | VA | Primary |
Addresses
Primary practice location
103 Valley Center Dr
Staunton, VA 24401-5080
Mailing address
103 Valley Center Dr
Staunton, VA 24401-5080
Other practice location 1
15 Medical Park Ste 141
General Psychiatry Department
Columbia, SC 29203
Phone (803) 434-1433
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101269643 | VA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615939200000",
"number": "1407205834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 VALLEY CENTER DR",
"city": "STAUNTON",
"state": "VA",
"postal_code": "244015080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 VALLEY CENTER DR",
"city": "STAUNTON",
"state": "VA",
"postal_code": "244015080",
"telephone_number": "540-332-8000"
}
],
"practiceLocations": [
{
"address_1": "15 Medical Park Ste 141",
"address_2": "General Psychiatry Department",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "29203",
"country_code": "US",
"telephone_number": "803-434-1433",
"fax_number": "803-434-4062",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "JOSHUAH",
"middle_name": "DUNCAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-07",
"last_updated": "2021-03-17",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "SC",
"license": "LL39434",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0101269643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staunton, VA
- In Bloom Behavioral Health Care
- Integrated Business Prescriptions, Inc (Medical Center Pharmacy)
- Integrated Business Prescriptions, Inc (Medical Center Pharmacy)
- Integrative Communication Health Services, Inc (Wolfe Speech Therapy Plus)
- Intrepid of the Appalachians, Inc. (Intrepid USA Hospice)
- Thomas Addison Jackson, RPRS QMHP-A
- Cary Jacob, M.ED., CCC-SLP
- Carroll Stockton Jacobs, N.D.
- Sherri E Jacobs, ND
- Timothy Jana, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.