Active NPI
Thomas Morton Jackson, MD
- Clinical Pathology/Laboratory Medicine Physician
- San Francisco, CA
National Provider Identifier
1427017151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- License
- G28421
- Practice address
- 3700 California St
San Francisco, CA 94118 - Phone
- (415) 600-2200
- Fax
- (415) 750-6001
- NPI assigned
- Mar 21, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | G28421 | CA | Primary |
Addresses
Primary practice location
3700 California St
San Francisco, CA 94118
Mailing address
PO Box 26060
Fresno, CA 93729
Phone (559) 455-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G284210 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G28421 | CA | MD | Clinical Pathology/Laboratory Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202774400000",
"number": "1427017151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26060",
"city": "FRESNO",
"state": "CA",
"postal_code": "93729",
"telephone_number": "559-455-4000",
"fax_number": "559-455-4004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 CALIFORNIA ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94118",
"telephone_number": "415-600-2200",
"fax_number": "415-750-6001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "THOMAS",
"middle_name": "MORTON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-21",
"last_updated": "2008-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "CA",
"license": "G28421",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G284210",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.