Individual provider Active NPI

Heath Owen Jackson, DPM

  • Podiatrist
  • Granbury, TX
National Provider Identifier
1528629177
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
3174 Issued in TX
Practice address
1008 Paluxy Rd
Granbury, TX 76048-2397
Phone
(817) 573-7178
NPI assigned
Jun 25, 2019
Last updated
Aug 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 3174 TX Primary

Addresses

Primary practice location

1008 Paluxy Rd
Granbury, TX 76048-2397

Mailing address

1008 Paluxy Rd
Granbury, TX 76048-2397
Phone (817) 573-7178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220813000614 TX Practitioner - Podiatry 9537542287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard M. Adams, DPM, PAGroup PAC ID 6709888167, 3 clinicians

Practice addresses (Care Compare)

1008 Paluxy Rd
Granbury, TX 76048-2397
Phone 81757371781

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.49 of 100Reported as group
Quality
44.99
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue262
Removal of skin lesions1-10
Removal of nail tissue46
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3174TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Richard M Adams DPM PA Single Specialty CurrentSince Aug 1, 2022 Accepting new patients
Glen Rose Healthcare, Inc Single Specialty PastSince Aug 1, 2022 Accepting new patients

Locations

1008 Paluxy Rd
Granbury, TX 76048
Phone (254) 897-1636

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1948/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/8b5675f4-fabf-49b9-90d5-2630480a3d7a/

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1528629177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 PALUXY RD",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760482397",
            "telephone_number": "817-573-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 PALUXY RD",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760482397",
            "telephone_number": "817-573-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HEATH",
        "middle_name": "OWEN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "3174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.