Elizabeth Anne Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4064 Issued in CO

Practice address

1830 Blake Ave
Glenwood Springs, CO 81601-4275

Phone

(970) 945-8503

Fax

(970) 945-0253

NPI assigned

Oct 21, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Elizabeth Anne Miller Former name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Glenwood Medical Associates PC 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley View Hospital Association Hospital, Glenwood Springs, CO, CCN 060075

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Glenwood Medical Assoc

  • Family Medicine Physician
  • Glenwood Springs, CO
  • NPI 1427191501

  CO

  Medicare reassignment Care Compare group NPD
• Valley View Hospital Association

  • Emergency Care Clinic/Center
  • Glenwood Springs, CO
  • NPI 1114654795

  CO

  Medicare reassignment NPD
• Pathology Assoc of the Roaring Fork

  • Anatomic Pathology & Clinical Pathology Physician
  • Glenwood SPGS, CO
  • NPI 1386624203
  NPD
• Valley View Hospital Association

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Carbondale, CO
  • NPI 1457235202
  NPD
• Valley View Hospital Association

  • Surgery Physician
  • Glenwood SPGS, CO
  • NPI 1518353218
  NPD
• Valley View Hospital Association

  • Urgent Care Clinic/Center
  • Glenwood Springs, CO
  • NPI 1790397008
  NPD
• GMJM, LLC

  • Physical Therapist
  • Glenwood Springs, CO
  • NPI 1386716454
  NPD (past)
• Atlanta Primary Care Peachtree, PC

  • Specialist
  • Newnan, GA
  • NPI 1477573293
  NPD (past)
• William C. Lambert M.D.

  • Family Medicine Physician
  • Tyrone, GA
  • NPI 1922041714
  NPD (past)

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

• Valley View Hospital Association

  • Ambulatory Surgical Clinic/Center
  • Basalt, CO
  • NPI 1649885849

  Hospital

  Care Compare affiliation
• Valley View Hospital Association

  • General Acute Care Hospital
  • Glenwood Springs, CO
  • NPI 1982668133

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1497065627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 BLAKE AVE",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014275",
            "telephone_number": "970-945-8503",
            "fax_number": "970-945-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 BLAKE AVE",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014275",
            "telephone_number": "970-945-8503",
            "fax_number": "970-945-0253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1906 Blake Ave",
            "address_purpose": "LOCATION",
            "city": "Glenwood Spgs",
            "state": "CO",
            "postal_code": "816014227",
            "country_code": "US",
            "telephone_number": "970-928-0808",
            "fax_number": "970-945-5738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-21",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "4064",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5995",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "MILLER",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carole Inglis, CNM
• Susan Jennifer Inscore, MD
• Emily J Ipsen, CNTP, MNT
• James Ireland, LPC
• Felipe Ituarte, M.D.
• James a O'Donnell, MD, PC
• Sandra Lynne Jammaron
• Deborah Jaouen, LMT,
• Edlin Jara-Molinar, PA
• Eric Jernigan, MD

• All providers in Glenwood Springs, CO
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.