David B Jackson, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

00018093 Issued in AL

Practice address

4410 Watermelon Rd
Northport, AL 35473-5204

Phone

(205) 345-1520

Fax

(205) 345-1761

NPI assigned

Jun 8, 2006

Last updated

Dec 23, 2010By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Merit-based Incentive Payment System (MIPS)

Final score

93.04 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

76.79

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• bcbs alabama network 01H0
• bcbs alabama network 01E0
• bcbs alabama network 01A0
• bcbs alabama network 01B0
• bcbs alabama network 01G0

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.

• Alabama Dermatology Associates, PC

  • Specialist
  • Northport, AL
  • NPI 1033128897
  Medicare reassignment NPD

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293062400000",
    "number": "1710928296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735204",
            "telephone_number": "205-345-1520",
            "fax_number": "205-345-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735204",
            "telephone_number": "205-345-1520",
            "fax_number": "205-345-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "00018093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000022709",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051022709",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Octavia Ingram, DNP, FNP-C, PMHNP-BC
• Innovative Health Practice Center, LLC
• Brock Isom
• Raychelle Ivie, CPHT
• Alicia Ladonna Jackson, PT
• Lindsey Sexton Jackson, CRNP
• William Jacobs, DPT
• Ashok Jagani, MD
• James River SCLH
• James T. Barnett, Jr., MD, PC (RSP The Physiatry Group)

• Dermatology Physician in Northport, AL
• Providers in Northport, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; 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.