Individual provider Active NPI

Albert Jerome Jackson Jr., MD

  • Anesthesiology Physician
  • Waterloo, IA
National Provider Identifier
1417168667
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
37967 Issued in IA
Practice address
2710 Saint Francis Dr
Ste 410
Waterloo, IA 50702-5619
Phone
(319) 272-5000
NPI assigned
May 26, 2007
Last updated
Jan 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 85529 SC
Anesthesiology Physician 207L00000X 37967 IA Primary
Anesthesiology Physician 207L00000X 85264 WI

Addresses

Primary practice location

2710 Saint Francis Dr
Ste 410
Waterloo, IA 50702-5619

Mailing address

2710 Saint Francis Dr Ste 410
Waterloo, IA 50702-5634
Phone (319) 272-5000

Other practice location 1

2116 Craig Rd
Eau Claire, WI 54701-6118
Phone (715) 858-4610

Other practice location 2

7 Independence Pt Ste 300
Greenville, SC 29615-4569
Phone (864) 522-3700

Other identifiers 1

IdentifierTypeStateIssuer
BP2-0023863OtherINSTITUTIONAL PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA, SC, WI4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20190621001742 NC Practitioner - Anesthesiology 7810062809 Reassigns benefits to 1 organization
I20190812000748 VA Practitioner - Anesthesiology 7810062809 Reassigns benefits to 1 organization
I20210512000354 SC Practitioner - Anesthesiology 7810062809 Reassigns benefits to 2 organizations
I20241224001521 WI Practitioner - Anesthesiology 7810062809 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, shared by 28 NPIs, 1,195 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

2310 Craig Rd
Eau Claire, WI 54701-6128
Phone (715) 858-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.33 of 100Reported as group
Quality
75.48
Promoting interoperability
100
Improvement activities
40
Cost
72.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37967IAMDAnesthesiology Physician
85529SCMDAnesthesiology Physician
85264WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc CurrentSince Dec 18, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 18, 2024 Accepting new patients
MCHS Hospitals Inc Anesthesiology Current Accepting new patients
Flambeau Hospital Inc CurrentSince Dec 18, 2024 Accepting new patients
Beach Anesthesia, LLC Anesthesiology CurrentSince May 8, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 18, 2024 Accepting new patients
MCHS Hospitals Inc Anesthesiology CurrentSince Dec 18, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 18, 2024 Accepting new patients
Memorial Hospital Inc CurrentSince Dec 18, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Dec 18, 2024 Accepting new patients
Medstream Anesthesia PLLC Anesthesiology CurrentSince May 1, 2019 Accepting new patients
Flambeau Hospital Inc CurrentSince Dec 18, 2024 Accepting new patients
Marshfield Clinic Inc CurrentSince Dec 18, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 18, 2024 Accepting new patients

Locations

566 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 436-1352

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

109 Blarney Dr
Columbia, SC 29223
Phone (803) 865-8200

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

200 Hospital Dr
Galax, VA 24333
Phone (276) 236-6011

6801 Governor Gc Peery Hwy
Richlands, VA 24641
Phone (276) 523-8600

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

2116 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1180137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1417168667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 SAINT FRANCIS DR STE 410",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025634",
            "telephone_number": "319-272-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 SAINT FRANCIS DR",
            "address_2": "STE 410",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025619",
            "telephone_number": "319-272-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2116 Craig Rd",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016118",
            "country_code": "US",
            "telephone_number": "715-858-4610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 Independence Pt Ste 300",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296154569",
            "country_code": "US",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALBERT",
        "middle_name": "JEROME",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-26",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "85529",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "37967",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "85264",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP2-0023863",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.