Tamar Yolanda Jackson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C1-0009102 Issued in DE

Practice address

4755 Ogletown Stanton Rd
Christiana Care Hospital
Newark, DE 19718-2200

Phone

(302) 733-5586

Fax

(302) 733-5833

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DE, GA2 enrollments

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 2

Specialty

Internal Medicine

Education

George Washington University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment Care Compare group NPD
• Vision Family Medical LLC

  • Family Medicine Physician
  • Newark, DE
  • NPI 1831900869
  Medicare reassignment
• Bayhealth Hospitalist, LLC

  • Hospitalist Physician
  • Milford, DE
  • NPI 1750527297
  NPD (past)
• Christiana Medical Group, PA

  • Hospitalist Physician
  • Newark, DE
  • NPI 1841231149
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1730213638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 CONTINENTAL DR",
            "address_2": "SUITE 200",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134305",
            "telephone_number": "302-366-1868",
            "fax_number": "302-366-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "address_2": "CHRISTIANA CARE HOSPITAL",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-5586",
            "fax_number": "302-733-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TAMAR",
        "middle_name": "YOLANDA",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C70003469",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0009102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6875 Douglas Blvd Ste A",
            "city": "Douglasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301357155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dawn Jackson
• Jennifer J Jackson, MS, LPC
• Kelly Jean Jackson, COTA
• Leah Ann Jackson, LMHC
• Michael Jackson, M.A., N.C.C,
• Brooke L Jacob, RD
• Tonya Jacobs, LPCMH
• Alexander M. Jacobson, M.D.
• Matthew David Jacobson, MD
• Jennifer Jacotin, LCSW

• Internal Medicine Physician in Newark, DE
• Providers in Newark, DE by specialty
• Internal Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.