NPIMap

Organization Active NPI

Jabez F. Jackson, Jr., M.D., PA

  • Obstetrics & Gynecology Physician
  • Newport, AR
National Provider Identifier
1457360885
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
C-4208 Issued in AR
Legal business name
JABEZ F. JACKSON, JR., M.D., PA
Practice address
1201 McLain St
Newport, AR 72112-3533
Phone
(870) 523-3289
Fax
(870) 523-4846
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Authorized official

Name
Dr. Jabez F Jackson Jr., M.D.NPI 1801866900
Title
President
Phone
(870) 523-3289

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X C-4208 AR Primary

Addresses

Primary practice location

1201 McLain St
Newport, AR 72112-3533

Mailing address

PO Box 1210
Newport, AR 72112-1210
Phone (870) 523-3289

Other identifiers 1

IdentifierTypeStateIssuer
126751002MedicaidAR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305504000000",
    "number": "1457360885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721121210",
            "telephone_number": "870-523-3289",
            "fax_number": "870-523-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MCLAIN ST",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721123533",
            "telephone_number": "870-523-3289",
            "fax_number": "870-523-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JABEZ F. JACKSON, JR., M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-05-16",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JABEZ",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-523-3289",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "C-4208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126751002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; 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.