Mary Kathleen Jackson

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

P6191 Issued in TX

Practice address

23802 Highway 59 N
Kingwood, TX 77339-1510

Phone

(281) 312-5400

Fax

(281) 312-5440

NPI assigned

May 7, 2009

Last updated

Apr 21, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mary Kathleen Croix Former name

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of Texas Medical School at Houston, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Obhg Texas Holdings PAGroup PAC ID 3577713072, 176 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Obhg Texas Holdings, P.a.

  • Obstetrics & Gynecology Physician
  • Austin, TX
  • NPI 1083917769
  Medicare reassignment Care Compare group NPD
• Woodlands Womens Care PLLC

  • Obstetrics & Gynecology Physician
  • Shenandoah, TX
  • NPI 1194185991
  Medicare reassignment NPD
• Privia Medical Group Gulf Coast, PLLC

  • Obstetrics & Gynecology Physician
  • Houston, TX
  • NPI 1578969465
  Medicare reassignment
• Memorial Hermann Health System

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1730132234
  NPD (past)

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1558595371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23802 HIGHWAY 59 N",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773391510",
            "telephone_number": "281-312-5465",
            "fax_number": "281-312-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23802 HIGHWAY 59 N",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773391510",
            "telephone_number": "281-312-5400",
            "fax_number": "281-312-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P6191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "328359001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "CROIX",
            "middle_name": "KATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• J&S Management Services PLLC
• Jack Jones Hearing Centers, Inc. (AudioNova)
• Anthony Bernard Jackson, LCSW
• Kayla Dawn Jackson, LCSW
• Marcia Jackson, LPC
• Melanie Jackson
• Rakeya Jackson, RBT
• Anastasia Gallagher Jacobs, APRN FNP-C
• Jenny Jacobs, LPC
• Sharona Jacobs, LCSW

• Obstetrics & Gynecology Physician in Kingwood, TX
• Providers in Kingwood, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.