NPIMap

Individual provider Active NPI

George Woody Jackson, M.D.

  • Internal Medicine Physician
  • Highland, AR
National Provider Identifier
1497824304
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N7190 Issued in AR
Practice address
1440 Highway 62 412
Highland, AR 72542-9497
Phone
(870) 856-6000
Fax
(870) 856-6001
NPI assigned
Nov 6, 2006
Last updated
Apr 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N7190 AR Primary

Addresses

Primary practice location

1440 Highway 62 412
Highland, AR 72542-9497

Mailing address

1440 Highway 62 412
Highland, AR 72542-9497
Phone (870) 856-6000

Other identifiers 1

IdentifierTypeStateIssuer
112923001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621001335 AR Practitioner - Internal Medicine 8123003571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1440 Hwy 62 412
Highland, AR 72542-9497
Phone (870) 257-3027

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
17.88 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
59.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N7190ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. George W. Jackson PA Internal Medicine CurrentSince Jun 1, 2001 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1440 Highway 62 412
Highland, AR 72542
Phone (870) 257-4488

Organizations & group practices 2

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.

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1497824304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 HIGHWAY 62 412",
            "city": "HIGHLAND",
            "state": "AR",
            "postal_code": "725429497",
            "telephone_number": "870-856-6000",
            "fax_number": "870-856-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 HIGHWAY 62 412",
            "city": "HIGHLAND",
            "state": "AR",
            "postal_code": "725429497",
            "telephone_number": "870-856-6000",
            "fax_number": "870-856-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GEORGE",
        "middle_name": "WOODY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "N7190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112923001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, AR

Sources for this page

Verify at the official NPI Registry.