Fredrick J Jackson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

S553TA209 Issued in AL

Practice address

8436 Vaughn Rd
Montgomery, AL 36117-8862

Phone

(334) 271-3900

Fax

(334) 271-3915

NPI assigned

Jul 5, 2006

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Optometry

Education

University Alabama Birmingham - School of Optometry, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyecare Associates, Inc.Group PAC ID 0749254001, 52 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fjackson@direct.eyecare-partners.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.

• Eyecare Associates, Inc.

  • Eyewear Supplier
  • Birmingham, AL
  • NPI 1710012877

  Optometrist

  Medicare reassignment Care Compare group NPD
• Eyecare Associates, Inc.

  • Optometrist
  • Montgomery, AL
  • NPI 1871475038
  NPD
• Eyecare Associates, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Jasper, AL
  • NPI 1255490041
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1609807015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8436 VAUGHN RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178862",
            "telephone_number": "334-271-3900",
            "fax_number": "334-271-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8436 VAUGHN RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178862",
            "telephone_number": "334-271-3900",
            "fax_number": "334-271-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "FREDRICK",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S553TA209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008605730",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL51059948",
            "identifier": "BC51059948",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Jackson
• Anna Jackson, BCBA
• Candice Grace Jackson, NP-C
• Ciana Alexandria Jackson
• Debrica Jackson
• Jacqueline R Jackson
• Janet E. Jackson, M.ED., SLPC
• Janetta Jackson, LMSW
• Jeremy Jackson
• Joni Virginia Jackson

• Optometrist in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.