Jay Ruswin Jackson, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MD016808E Issued in PA

Practice address

2050 S Queen St
Ste 200
York, PA 17403-4829

Phone

(717) 812-2316

Fax

(717) 848-5540

NPI assigned

Jul 6, 2006

Last updated

Feb 10, 2014By 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 12

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• York Hospital

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • York, PA
  • NPI 1114885480
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1720010390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-812-2316",
            "fax_number": "717-812-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 S QUEEN ST",
            "address_2": "STE 200",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034829",
            "telephone_number": "717-812-2316",
            "fax_number": "717-848-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JAY",
        "middle_name": "RUSWIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD016808E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "060973",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "525991",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "7312",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-WMG",
            "identifier": "80827",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS-WMG",
            "identifier": "01475302",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS",
            "identifier": "030261",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4296841",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "1519360",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000768337",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH 65 PA",
            "identifier": "0068408000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG",
            "identifier": "1142788",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI-WMG",
            "identifier": "433281",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaasim Home Healthcare LLC
• Alexis Jackson
• Cassandra Mary Jackson, LSW
• Cortney Jackson, BCBA
• Douglas Scott Jackson, PHARM.D,
• Kevin Joseph Jackson, D.C.
• Kristen Jackson
• Rachael Ellen Jackson
• Sarah Jackson, MA, LPC
• Tiffany A Jackson, CNM

• Obstetrics & Gynecology Physician in York, PA
• Providers in York, PA by specialty
• Obstetrics & Gynecology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.