Garrett Jackson, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

2024018659 Issued in MO

Practice address

1 Hospital Dr
Columbia, MO 65212-1000

Phone

(573) 884-7796

NPI assigned

Jun 11, 2024

Last updated

Jun 11, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1639911514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652121000",
            "telephone_number": "573-884-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652121000",
            "telephone_number": "573-884-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GARRETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2024018659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nesreen Jaafar, MD
• Tyler Isaac-Carl Jackman, LCSW
• Jada Jackmon, RBT
• Alexandria Jackson
• Christopher Duane Jackson, M.D.
• Hunter Jackson
• Jesse Jose Jackson
• Kelly Faye Jackson, LCSW
• Keviana Y Jackson, MSW, LMSW
• Kimberly Jackson, RN

• Orthopaedic Surgery Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Orthopaedic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.