Amy Kolleen Jackson, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

35121125 Issued in OH

Practice address

6482 E Main St
Suite B
Reynoldsburg, OH 43068-7312

Phone

(617) 856-0327

Fax

(614) 856-3300

NPI assigned

Jul 10, 2009

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

Medicare fee-for-service enrollment

Enrolled in OH

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

Ohio State University College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Summa Health System Hospital, Akron, OH, CCN 360020

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajackson25492@summahealth-direct.org
• Direct secure messaging: amy.jackson.p3@direct.acoog.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Summa Physicians LLC

  dba Summa Health Medical Group

  • Obstetrics & Gynecology Physician
  • Akron, OH
  • NPI 1235167719
  Medicare reassignment Care Compare group NPD
• Summa Physicians LLC

  dba Summa Health Medical Group

  • Surgery Physician
  • Akron, OH
  • NPI 1427009638
  NPD
• Summa Physicians LLC

  dba Summa Health Medical Group

  • Geriatric Medicine (Internal Medicine) Physician
  • Uniontown, OH
  • NPI 1457662769
  NPD
• Summa Health System

  • General Acute Care Hospital
  • Akron, OH
  • NPI 1396765681
  NPD (past)
• Summa Physicians LLC

  dba Summa Health Medical Group

  • Vascular Surgery Physician
  • Akron, OH
  • NPI 1891743332
  NPD (past)

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

• Summa Health System

  dba Summa Health System Ignatia Hall South

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Canton, OH
  • NPI 1295036762

  Hospital

  Care Compare affiliation
• Summa Health System

  • General Acute Care Hospital
  • Akron, OH
  • NPI 1396765681
  Care Compare affiliation
• Summa Health System

  • Clinical Medical Laboratory
  • Barberton, OH
  • NPI 1609263706

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1609005727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6482 E MAIN ST",
            "address_2": "SUITE B",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430687312",
            "telephone_number": "617-856-0327",
            "fax_number": "614-856-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6482 E MAIN ST",
            "address_2": "SUITE B",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430687312",
            "telephone_number": "617-856-0327",
            "fax_number": "614-856-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "AMY",
        "middle_name": "KOLLEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35121125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darryl D Isom
• Ivory Home Health Services Inc.
• J & J's Consulting Agency Specializing in Nursing and Home Health Care
• J. Scott Craig, PCC, LLC (J. Scott Counseling)
• Amber M Jackson
• Keyonna Jackson
• Lakeisha Nadine Jackson
• Linda Jackson
• Sherome Jackson
• Susan Jackson, PHARMACIST

• Obstetrics & Gynecology Physician in Reynoldsburg, OH
• Providers in Reynoldsburg, OH by specialty
• Obstetrics & Gynecology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.