Mark T Jackson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

200201481 Issued in NC

Practice address

500 Centre Park Dr
Asheville, NC 28805-1262

Phone

(828) 254-4337

Fax

(828) 251-9240

NPI assigned

May 5, 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

Enrolled in NC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.jackson.1@30671.direct.athenahealth.com
• Direct secure messaging: markjackson@map.allscriptsdirect.net

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.

• Mountain Area Pediatric Associates, P.a.

  • Pediatrics Physician
  • Asheville, NC
  • NPI 1164470134
  Medicare reassignment NPD

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1447208871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CENTRE PARK DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288051262",
            "telephone_number": "828-254-4337",
            "fax_number": "828-251-9240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CENTRE PARK DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288051262",
            "telephone_number": "828-254-4337",
            "fax_number": "828-251-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARK",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200201481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89135C7",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathon Troy Jackson
• Julie Ann Jackson
• Kimberly Taylor Jackson, M.A., LPA
• Larri Geyneece Jackson
• Laura Jackson, LPCA, LCASA
• Mary Jackson, RD
• Megan Elizabeth Jackson, LCSW
• Melanie Jackson, PHARM. D.
• Michala Alease Jackson, LCSW
• Rana Kaye Jackson, LCSW

• Pediatrics Physician in Asheville, NC
• Providers in Asheville, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.