Rebecca Grace Jackson, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P013617 Issued in NC

Practice address

1509 Doctors Cir BLDG C
Wilmington, NC 28401-7403

Phone

(910) 662-7500

Fax

(910) 662-7501

NPI assigned

Jul 28, 2020

Last updated

Oct 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Novant Health Medical Group Coastal Region LLCGroup PAC ID 2860809936, 577 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Novant Health Medical Group Coastal Region, LLC

  dba NHMGCR Cape Fear Heart

  • Cardiovascular Disease Physician
  • Wilmington, NC
  • NPI 1649865791
  Medicare reassignment Care Compare group NPD
• NMG Health Services LLC

  • Maternal & Fetal Medicine Physician
  • Bolivia, NC
  • NPI 1558242495
  NPD
• Novant Health Medical Group Coastal Region, LLC

  dba Nhmgcr Neurology

  • Neurology Physician
  • Wilmington, NC
  • NPI 1316523822
  NPD

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1437768256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 DOCTORS CIR BLDG C",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017403",
            "telephone_number": "910-662-7500",
            "fax_number": "910-662-7501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Wellington Ave",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017652",
            "country_code": "US",
            "telephone_number": "910-392-4881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5145 S College Rd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284122207",
            "country_code": "US",
            "telephone_number": "910-662-6000",
            "fax_number": "910-792-0160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "REBECCA",
        "middle_name": "GRACE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Alan Jackson, LCMHCA
• Latoya Jackson, MS,QP
• Mary Louise Jackson, NP
• Naomi Namrota Jackson, PA-C
• P Brian Jackson, OD
• Tiffany L Jackson, O.D.
• Woody H Jackson, MD
• Jacob R. Long, DDS, PLLC
• Jacob's Business Ventures (A Loyal Home Care)
• Cheyanne Nevaeh Jacobs

• Clinical Social Worker in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.