Michelle S. Jackson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

00018274 Issued in AL

Practice address

2423 Schillinger Rd S
Mobile, AL 36695-4136

Phone

(251) 605-9506

Fax

(251) 660-5949

NPI assigned

Aug 1, 2006

Last updated

Jan 2, 2019By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1568479715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD",
            "address_2": "STE A101",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086767",
            "telephone_number": "251-378-6209",
            "fax_number": "251-378-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 SCHILLINGER RD S",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366954136",
            "telephone_number": "251-605-9506",
            "fax_number": "251-660-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHELLE",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00018274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051553281",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julianne Griffin Jackson, LPC
• Madison Jackson
• Maggie Cayson Jackson
• Melanie Hope Jackson, PHD, LLC
• Michael Jackson Jr.
• Regina Jackson
• Savannah Rommel Jackson, MS, LPC, LCPC
• Sharcarus Jackson
• Sharie Jackson, MSN,RN
• Trevor Glenn Jackson, DC

• Internal Medicine Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.