Active NPI
Robert L Jackson III, PA
- Physician Assistant
- Asheville, NC
National Provider Identifier
1477874675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 100246
- Practice address
- 91 Mount Carmel Rd
Asheville, NC 28806-9763 - Phone
- (828) 253-3717
- NPI assigned
- Jun 22, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 100246 | NC | Primary |
Addresses
Primary practice location
91 Mount Carmel Rd
Asheville, NC 28806-9763
Mailing address
PO Box 602373
Charlotte, NC 28260-2373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277164800000",
"number": "1477874675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 602373",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282602373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 MOUNT CARMEL RD",
"city": "ASHEVILLE",
"state": "NC",
"postal_code": "288069763",
"telephone_number": "828-253-3717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ROBERT",
"middle_name": "L",
"name_suffix": "III",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-22",
"last_updated": "2010-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "100246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Asheville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.