Anthony Benedict Jackson, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

JACK-AA4P9 Issued in NC

Practice address

3724 Raleigh Road Pkwy W
Wilson, NC 27896-9742

Phone

(252) 246-8840

NPI assigned

Aug 24, 2020

Last updated

Jul 18, 2022By 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 NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.95 of 100Reported as apm

Quality

82.44

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anthony.jackson@125256184.chartlogic.direct-ci.com

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

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment Care Compare group NPD
• S1 Medical Holdings LLC

  • Pain Medicine (Anesthesiology) Physician
  • Sumter, SC
  • NPI 1891343695
  NPD (past)

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1689287328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 BULL RIVER ST",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275273402",
            "telephone_number": "850-543-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 RALEIGH ROAD PKWY W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278969742",
            "telephone_number": "252-246-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANTHONY",
        "middle_name": "BENEDICT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-24",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "JACK-AA4P9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Interim Healthcare of the Triad, Inc.
• Interim Healthcare of the Triad, Inc.
• George Coupland Isaacs, M.D.
• Lisal B. Isaacs, DMD
• J & L Summerville Academy
• Matthew Jackson, PHARMD
• Megan Alexandra Jackson
• Shannon Byrd Jackson, RD, LDN
• Sopna E Jacob, MD
• Amanda H Janda, PA-C

• Acute Care Nurse Practitioner in Wilson, NC
• Providers in Wilson, NC by specialty
• Acute Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.