Alan E. Jackson, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

185984-1205 Issued in UT

Practice address

201 E 5900 S
Suite 101
Salt Lake City, UT 84107-7379

Phone

(801) 268-6600

Fax

(801) 268-6602

NPI assigned

Mar 21, 2006

Sex

Male

Sole proprietor

Yes

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 UT

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

Ophthalmology

Education

Tulane University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Cottonwood Eye and Laser Center

  • Ophthalmology Physician
  • Murray, UT
  • NPI 1952623712
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1467411223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 5900 S",
            "address_2": "SUITE 101",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841077379",
            "telephone_number": "801-268-6600",
            "fax_number": "801-268-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 5900 S",
            "address_2": "SUITE 101",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841077379",
            "telephone_number": "801-268-6600",
            "fax_number": "801-268-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALAN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "185984-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Adrian Jackman
• Megan S Jackman, FNP-BC
• Sherry A Jackman
• Vicki L Jackman, APRN
• Stacey Jackson-Roberts, LCSW-C
• Alexander Jackson, LCSW
• Bailey Jackson
• Brent A Jackson
• Christopher G. Jackson, MD
• David Jackson

• Ophthalmology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Ophthalmology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.