Jackson Ophthalmology Group LTD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

13385 Issued in NV

Legal business name

JACKSON OPHTHALMOLOGY GROUP LTD

Practice address

7190 Smoke Ranch Rd Ste 110
Las Vegas, NV 89128-8398

Phone

(702) 825-2085

Fax

(702) 852-5743

NPI assigned

Feb 23, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Todd L Jackson, M.D.

Title

President

Phone

(702) 472-9902

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prestige Laser & Cataract Institute Doing business as

Locations

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1699048512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8230 W SAHARA AVE",
            "address_2": "SUITE 111",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891178959",
            "telephone_number": "702-472-9902",
            "fax_number": "702-823-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7190 SMOKE RANCH RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891288398",
            "telephone_number": "702-825-2085",
            "fax_number": "702-852-5743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 E Bonanza Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891103505",
            "country_code": "US",
            "telephone_number": "702-825-2085",
            "fax_number": "702-852-5743",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2390 W Horizon Ridge Pkwy",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890525079",
            "country_code": "US",
            "telephone_number": "702-825-2085",
            "fax_number": "702-852-5743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKSON OPHTHALMOLOGY GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-472-9902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NV",
            "license": "13385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1609063775",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Laser & Cataract Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen Stewart Jacks, MD
• Jennie Jackson Cherry
• Sonya Renae Jackson Huddleston
• Shaw Jackson Jr
• Jackson Medical Enterprises
• Jackson Psychiatric and Primary Care Services
• Lisa Maurine Jackson Smith
• Shaw Jackson Sr
• Symphony Jackson Walker, CNA
• Davita Jackson-Clark, FNP

• Ophthalmology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ophthalmology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.