Active NPI
Elizabeth I Jackson
- Internal Medicine Physician
- Denver, CO
National Provider Identifier
1437286457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 125447
- Practice address
- 10400 E Alameda Ave
Denver, CO 80247-5104 - Phone
- (303) 360-1505
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125447 | CO | Primary |
Addresses
Primary practice location
10400 E Alameda Ave
Denver, CO 80247-5104
Mailing address
10400 E Alameda Avenue
Denver, CO 80247-5199
Phone (303) 338-4545
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014499 | Other | KAISER-COMMERCIAL NUMBER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125447 | CO | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1437286457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10400 E ALAMEDA AVENUE",
"city": "DENVER",
"state": "CO",
"postal_code": "802475199",
"telephone_number": "303-338-4545",
"fax_number": "303-360-1464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10400 E ALAMEDA AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802475104",
"telephone_number": "303-360-1505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ELIZABETH",
"middle_name": "I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "125447",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER-COMMERCIAL NUMBER",
"identifier": "014499",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.