Vadean L. Jackson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M4199 Issued in TX

Practice address

4438 Centerview
San Antonio, TX 78228-1440

Phone

(210) 280-0040

Fax

(210) 280-0060

NPI assigned

Sep 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Family Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vadean.jackson@wellmed.eclinicaldirectplus.com

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.

• Wellmed Medical Group, PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1437156486

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Community Medicine Associates

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1245313329
  Medicare reassignment NPD
• Wellmed Medical Group, P.a.

  • Family Medicine Physician
  • Austin, TX
  • NPI 1437457710
  NPD
• Wellmed Medical Group, P.a.

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1740588243
  NPD

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1699875336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4438 CENTERVIEW",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281440",
            "telephone_number": "210-280-0040",
            "fax_number": "210-280-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4438 CENTERVIEW",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281440",
            "telephone_number": "210-280-0040",
            "fax_number": "210-280-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "VADEAN",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M4199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICAID",
            "identifier": "192732902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICARE",
            "identifier": "TXB153202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheryd J. Jackson, RNC, MS, WHNP
• Stephanie Renee Jackson, OTR
• Susan Michelle Jackson, RPH
• Teresa Anne Jackson, LCSW
• Todd Steven Jackson, RN
• Valencia Jackson
• Whitney Jackson, CFNP
• Whitney Ree Ann Jackson, LCDC I
• Jerin Jacob, DDS
• Mark Alan Jacob, M.D.

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.