Mollie J Jackson, DO

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

05-37265 Issued in KS

Practice address

3901 Rainbow Blvd
Department of Gastroenterology
Kansas City, KS 66160-8500

Phone

(913) 588-3283

Fax

(913) 588-3975

NPI assigned

May 29, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KS

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

GastroenterologyAlso: Internal Medicine

Education

Kansas City College of Medicine and Surgery, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
• University of Kansas Health System Olathe Hospital Hospital, Olathe, KS, CCN 170049

Merit-based Incentive Payment System (MIPS)

Final score

92.91 of 100Reported as apm

Quality

77.02

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjackson302625@direct.kuha.org

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.

• Kansas University Physicians Inc

  • Internal Medicine Physician
  • Kansas City, KS
  • NPI 1003858333
  Medicare reassignment Care Compare group NPD
• Kansas University Physicians Inc

  • Cardiovascular Disease Physician
  • Kansas City, KS
  • NPI 1407637291
  NPD
• Kansas University Physicians Inc

  dba KU Internal Medicine

  • Internal Medicine Physician
  • Kansas City, KS
  • NPI 1699811521
  NPD
• Indiana University Health, Inc

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1376586719
  NPD (past)

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

• Olathe Medical Center Inc

  • General Acute Care Hospital
  • Olathe, KS
  • NPI 1144266115
  Care Compare affiliation
• University of Kansas Hospital Authority

  dba University of Kansas Hospital / University of Kansas Cancer Center

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1629369681
  Care Compare affiliation
• University of Kansas Hospital Authority

  dba The University of Kansas Hospital

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1649259656
  Care Compare affiliation

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1619135373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "DEPARTMENT OF GASTROENTEROLOGY",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-3283",
            "fax_number": "913-588-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "DEPARTMENT OF GASTROENTEROLOGY",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-3283",
            "fax_number": "913-588-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MOLLIE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02003644",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "02003644A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02003644A",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KS",
            "license": "05-37265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200984700",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200984700",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Stevens Jackson, M.D.
• Derrick Jackson
• Jordan Alexa Jackson, PT, DPT, SCS
• Kelsey Nicole Jackson, APRN-CNP
• Lateasha C Jackson
• Quinn Michelle Jackson, M.D.
• Randolph Thomas Jackson, M.D.
• Robert Sean Jackson, M.D.
• Sara Jackson, LSCSW
• Seth Jackson, DPT

• Gastroenterology Physician in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Gastroenterology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.