NPIMap

Individual provider Active NPI

Richard Allen Jackson, M.D.

  • Internal Medicine Physician
  • Richmond, VA
National Provider Identifier
1578644290
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101030877 Issued in VA
Practice address
304 E Leigh St
Richmond, VA 23219-1410
Phone
(804) 225-7148
Fax
(804) 225-7159
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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 0101030877 VA Primary

Addresses

Primary practice location

304 E Leigh St
Richmond, VA 23219-1410

Mailing address

304 E Leigh St
Richmond, VA 23219-1410
Phone (804) 225-7148

Other identifiers 14

IdentifierTypeStateIssuer
0542922OtherVAANTHEM/TRIGON/HMO/PPO/HEA
541588928OtherVAUNITEDHEALTHCARE
541588928OtherVAVA COORDINATED CARE
44130OtherVASENTAR
541588928OtherVASOUTHERHEALTH
541588928OtherVAVA PREMIER
541588928OtherVAPHCS
006044140MedicaidVA
541588928OtherVAVIRGINIA HEALTH NETWORK
C03251OtherVAMCR GROUP#
491268OtherVAAETNA/HMO/PPO
041765-00000OtherVAQUAL CHOICE
110054158OtherVAMCR RAILROAD
541588928/4971410007OtherVACIGNA/HMO/PPO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20040419000366 VA Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 2961497094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists)
Education
Howard University College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dominion Medical Associates, Inc.Group PAC ID 6406747609, 2 clinicians

Practice addresses (Care Compare)

304 E Leigh St
Richmond, VA 23220
Phone (804) 225-7148

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Medical Associate, Inc Current Accepting new patients
Dominion Medical Associates, Inc Internal Medicine CurrentSince Jan 1, 1990 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1510 N 28th St
Ste 300
Richmond, VA 23223
Phone (804) 644-1665

1510 N 28th St
Ste 204
Richmond, VA 23223
Phone (804) 225-7177

304 E Leigh St
Richmond, VA 23219
Phone (804) 225-7148

Interoperability endpoints

  • Direct secure messaging: richardjackson@dmna.allscriptsdirect.net

Organizations & group practices 3

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1578644290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 E LEIGH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232191410",
            "telephone_number": "804-225-7148",
            "fax_number": "804-225-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 E LEIGH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232191410",
            "telephone_number": "804-225-7148",
            "fax_number": "804-225-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RICHARD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101030877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM/TRIGON/HMO/PPO/HEA",
            "identifier": "0542922",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "541588928",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA COORDINATED CARE",
            "identifier": "541588928",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTAR",
            "identifier": "44130",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERHEALTH",
            "identifier": "541588928",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA PREMIER",
            "identifier": "541588928",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "541588928",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006044140",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "541588928",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR GROUP#",
            "identifier": "C03251",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/HMO/PPO",
            "identifier": "491268",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAL CHOICE",
            "identifier": "041765-00000",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR RAILROAD",
            "identifier": "110054158",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA/HMO/PPO",
            "identifier": "541588928/4971410007",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.