Rubie Sue Jackson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

D77385 Issued in MD

Practice address

2000 Medical Parkway
Suite 200
Annapolis, MD 21401

Phone

(443) 481-5300

Fax

(443) 481-6705

NPI assigned

Mar 10, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Rubie Sue Maybury Former name

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Specialty

General Surgery

Education

State University of New York at Stony Brook, School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rjackson29539@direct.aahs.org

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.

• Luminis Health Medical Group, LLC

  dba Luminis Health Maternal and Fetal Medicine

  • Maternal & Fetal Medicine Physician
  • Annapolis, MD
  • NPI 1073580205
  Medicare reassignment Care Compare group NPD
• Luminis Health Medical Group, LLC

  dba Annapolis Surgical Oncology Associates

  • Surgery Physician
  • Annapolis, MD
  • NPI 1649248485

  DC

  Medicare reassignment NPD
• Luminis Health Medical Group, LLC

  • Surgery Physician
  • Lanham, MD
  • NPI 1124829080
  NPD
• Luminis Health Medical Group, LLC

  dba The Cancer Survivorship Program

  • Medical Oncology Physician
  • Annapolis, MD
  • NPI 1255675021
  NPD
• Luminis Health Medical Group, LLC

  dba LH Primary Care North Hanson

  • Internal Medicine Physician
  • Bowie, MD
  • NPI 1720835010
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Luminis Health Medical Group, LLC

  dba AAMC Community Health Center

  • Internal Medicine Physician
  • Annapolis, MD
  • NPI 1477862308
  NPD (past)

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

• Luminis Health Anne Arundel Medical Center, Inc.

  dba Conexus Laboratories Inc.

  • Clinical Medical Laboratory
  • Annapolis, MD
  • NPI 1356885032

  Hospital

  Care Compare affiliation
• Luminis Health Anne Arundel Medical Center, Inc.

  • General Acute Care Hospital
  • Annapolis, MD
  • NPI 1477517225
  Care Compare affiliation

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

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1528209293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12622",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "04915",
            "telephone_number": "443-481-6573",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PARKWAY",
            "address_2": "SUITE 200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "443-481-5300",
            "fax_number": "443-481-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RUBIE",
        "middle_name": "SUE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-10",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D77385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213518300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUBIE",
            "last_name": "MAYBURY",
            "middle_name": "SUE",
            "credential": "MD.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kai Love Jackson, BT, RPHT
• Kendra Lorraine Jackson, LPC
• Lauren Riley Jackson
• Melanie Lynn Jackson, M.D.
• Nashota Lynn Jackson, LCPC, NCC
• Valencia Jackson
• Ashok Cherian Jacob, M.D, MPH
• Matthew Jacob
• Jeralyn Bernier Jacobs, MD
• Lawrence D. Jacobs, MD

• Surgery Physician in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.