Active NPI
Guy Jackson, M.D.
- Obstetrics & Gynecology Physician
- Baltimore, MD
National Provider Identifier
1659722239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- D0023997
- Practice address
- 425 N Chapel Gate LN
Baltimore, MD 21229-2430 - Phone
- (443) 996-4355
- NPI assigned
- Jun 25, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | D0023997 | MD | Primary |
Addresses
Primary practice location
425 N Chapel Gate LN
Baltimore, MD 21229-2430
Mailing address
425 N Chapel Gate LN
Baltimore, MD 21229-2430
Phone (443) 996-4355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0023997 | MD | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466812800000",
"number": "1659722239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 N CHAPEL GATE LN",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212292430",
"telephone_number": "443-996-4355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 N CHAPEL GATE LN",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212292430",
"telephone_number": "443-996-4355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "GUY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-25",
"last_updated": "2016-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MD",
"license": "D0023997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.