Jeffrey I Jackerson, D.O.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

C20004119 Issued in DE

Practice address

640 S State Street
Dept of Radiology
Dover, DE 19901-3530

Phone

(302) 674-2202

NPI assigned

Jan 18, 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Milford Diagnostic Imagine PA

  • Diagnostic Radiology Physician
  • Milford, DE
  • NPI 1689674533
  NPD (past)
• Milwaukee Surgical Specialists SC

  • Surgery Physician
  • Franklin, WI
  • NPI 1194052753
  NPD (past)

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1427038280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 W PARK PL STE 1100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532243636",
            "telephone_number": "414-359-5745",
            "fax_number": "414-359-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S STATE STREET",
            "address_2": "DEPT OF RADIOLOGY",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-674-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKERSON",
        "first_name": "JEFFREY",
        "middle_name": "I",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DE",
            "license": "C20004119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000601403",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uche Henry Isiocha, MD
• It Is Well Healthcare, LLC
• Hamza Samir Jaber, MD
• Jack R. Milligan M.D., P.a.
• Chenitra Jack
• Ebony Adele Jackson, CRNP
• Nicole Jackson, FNP, PMHNP
• Tyra Jackson
• Susan Lynn Jacobs, BCBA
• Amber Rose Jacobson

• Diagnostic Radiology Physician in Dover, DE
• Providers in Dover, DE by specialty
• Diagnostic Radiology Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.