Amy R Jackson

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

82152 Issued in SC

Practice address

1132 Spring St
Greenwood, SC 29646-3859

Phone

(864) 725-1680

Fax

(864) 725-1683

NPI assigned

May 21, 2019

Last updated

Jul 25, 2024By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Family Practice

Education

Edward Via Col of Osteo Medicine-Carolinas Campus, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians

Self Regional Healthcare PartnersGroup PAC ID 1557606118, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071
• Edgefield County Healthcare an Affiliate of Self R Hospital, Edgefield, SC, CCN 421304

Merit-based Incentive Payment System (MIPS)

Final score

94.7 of 100Reported as apm

Quality

89.4

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajackson261428@selfregional.direct-ci.net

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.

• Self Medical Group

  • Surgery Physician
  • Greenwood, SC
  • NPI 1982836847
  Medicare reassignment Care Compare group NPD
• Self Regional Healthcare

  dba Montgomery Center for Family Medicine of SRH

  • Family Medicine Physician
  • Greenwood, SC
  • NPI 1326067703
  Medicare reassignment Care Compare group NPD
• Self Regional Healthcare Partners

  dba Edgefield County Healthcare, An Affiliate of Self Regional Healthcare

  • Critical Access Hospital
  • Edgefield, SC
  • NPI 1922582105
  Medicare reassignment Care Compare group
• Self Medical Group

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Greenwood, SC
  • NPI 1538488457
  NPD
• Self Regional Healthcare

  dba Self Regional Neurology

  • Neurology Physician
  • Greenwood, SC
  • NPI 1285502559
  NPD
• Self Regional Healthcare

  dba Full Circle Care

  • Family Medicine Physician
  • Greenwood, SC
  • NPI 1386443752
  NPD
• Self Regional Healthcare Partners

  dba Edgefield Medical Center

  • Family Medicine Physician
  • Edgefield, SC
  • NPI 1053929208
  NPD
• Self Medical Group

  dba Advanced Gastroenterology

  • Gastroenterology Physician
  • Greenwood, SC
  • NPI 1841047560
  NPD (past)
• Self Regional Healthcare

  dba Self Medical Center Newberry

  • Family Medicine Physician
  • Newberry, SC
  • NPI 1548068398
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Self Regional Healthcare

  dba Pain Management Greenwood

  • Pain Medicine (Anesthesiology) Physician
  • Greenwood, SC
  • NPI 1013867498

  Hospital

  Care Compare affiliation
• Self Regional Healthcare

  dba SRH - Inpatient Services

  • General Acute Care Hospital
  • Greenwood, SC
  • NPI 1023046612
  Care Compare affiliation
• Self Regional Healthcare

  dba SRH - Outpatient Services

  • General Acute Care Hospital
  • Greenwood, SC
  • NPI 1407887003
  Care Compare affiliation
• Self Regional Healthcare

  dba Pain Management Laurens

  • Pain Medicine (Anesthesiology) Physician
  • Clinton, SC
  • NPI 1720938103

  Hospital

  Care Compare affiliation
• Self Regional Healthcare Partners

  dba Edgefield County Healthcare, An Affiliate of Self Regional Healthcare

  • Critical Access Hospital
  • Edgefield, SC
  • NPI 1922582105
  Care Compare affiliation

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1467019943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WELLS AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463837",
            "telephone_number": "864-725-4673",
            "fax_number": "864-725-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 SPRING ST",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463859",
            "telephone_number": "864-725-1680",
            "fax_number": "864-725-1683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AMY",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "82152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajackson261428@selfregional.direct-ci.net",
            "affiliation": "N",
            "address_1": "155 Academy Ave",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296463869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christy Michelle Irons, FNP-BC
• William David Isenhower Jr., MD
• Chaquinta Monique Isom, M.ED.
• Jabine Dialysis, LLC (Coronaca Home Dialysis)
• Adrienne Jackson
• Christa Jackson
• Michelle M Jackson
• Tabitha Jackson
• Tracey Ann Jackson, LBSW
• Ashley Jacobs, PHARMD

• Family Medicine Physician in Greenwood, SC
• Providers in Greenwood, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.