Kevin Jackson, CAA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

67.000265 Issued in OH

Practice address

6780 Mayfield Rd
Mayfield Heights, OH 44124-2203

Phone

(440) 312-4500

NPI assigned

Oct 21, 2015

Last updated

Oct 21, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Anesthesia Associates of Columbus PAGroup PAC ID 6901701135, 26 clinicians

Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229
• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• St Francis Hospital- Emory Healthcare Hospital, Columbus, GA, CCN 110129

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

96.48 of 100Reported as group

Quality

87.56

Promoting interoperability

100

Improvement activities

40

Cost

75.14

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anesthesia Associates of Columbus PA

  • Certified Registered Nurse Anesthetist
  • Columbus, GA
  • NPI 1740251248

  Anesthesiologist Assistant

  Medicare reassignment Care Compare group NPD
• Piedmont Anesthesia LLC

  • Anesthesiology Physician
  • Stockbridge, GA
  • NPI 1700474244
  Medicare reassignment Care Compare group NPD
• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• Mak Anesthesia Holdings LLC

  • Anesthesiology Physician
  • Kennesaw, GA
  • NPI 1912452939
  Medicare reassignment Care Compare group
• Amsol Anesthetists of Georgia, LLC

  • Certified Registered Nurse Anesthetist
  • Columbus, GA
  • NPI 1649224775
  Medicare reassignment NPD
• Grady Memorial Hospital Corporation

  dba Grady Health System

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1114243813
  Medicare reassignment NPD
• Sentry Anesthesia Management, LLC

  • Anesthesiology Physician
  • Newnan, GA
  • NPI 1134544794
  Medicare reassignment NPD
• Amsol Anesthetists of Georgia LLC-Hughston Surgical Center

  • Certified Registered Nurse Anesthetist
  • Columbus, GA
  • NPI 1164708400

  Anesthesiologist Assistant

  NPD
• Grady Memorial Hospital Corporation

  dba Grady Inpatient Rehabilitation Unit

  • Rehabilitation Hospital
  • Atlanta, GA
  • NPI 1336961119
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

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

• Kennestone Hospital, Inc.

  dba Wellstar Kennestone Hospital

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation
• Piedmont Newnan Hospital, Inc.

  • General Acute Care Hospital
  • Newnan, GA
  • NPI 1134133002
  Care Compare affiliation
• St Francis Health LLC

  dba St Francis Hospital

  • General Acute Care Hospital
  • Columbus, GA
  • NPI 1033228168
  Care Compare affiliation

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1477925287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 NORTHBORO DR",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441433429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6780 MAYFIELD RD",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441242203",
            "telephone_number": "440-312-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KEVIN",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-21",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OH",
            "license": "67.000265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bradley Paul Jenkins, DPT

• Anesthesiologist Assistant in Mayfield Heights, OH
• Providers in Mayfield Heights, OH by specialty
• Anesthesiologist Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.