Individual provider Active NPI

Erin W. Jackson, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Washington, DC
National Provider Identifier
1730323296
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
49778 Issued in TN
Practice address
900 23Rd St NW
Washington, DC 20037-2342
Phone
(202) 715-4337
Fax
(202) 741-2791
NPI assigned
Apr 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 49778 TN Primary
Internal Medicine Physician 207R00000X 49778 TN
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 036.139904 IL
Hospitalist Physician 208M00000X 49778 TN
Internal Medicine Physician 207R00000X 0101253099 VA

Addresses

Primary practice location

900 23Rd St NW
Washington, DC 20037-2342

Mailing address

900 23Rd St NW
Washington, DC 20037-2342
Phone (202) 741-2191

Other identifiers 4

IdentifierTypeStateIssuer
P01216006OtherTNRAILROAD
7100241590MedicaidKY
1531862MedicaidTN
6010875OtherTNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, DC2 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

Enrollment IDStateProvider typePAC IDDetails
I20130710000115 TN Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 9133364102 Reassigns benefits to 2 organizations
I20200329000500 DC Practitioner - Internal Medicine 9133364102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Internal Medicine
Education
East Tennessee State University Quillen College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Health System, Inc.Group PAC ID 5294646378, 512 clinicians

Practice addresses (Care Compare)

1924 Alcoa Hwy
Knoxville, TN 37920-1511

Hospital & facility affiliations

  • University Health System, Inc Hospital, Knoxville, TN, CCN 440015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101253099VAMDInternal Medicine Physician
036.139904ILMDHospice and Palliative Medicine (Internal Medicine) Physician
49778TNMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Health System, Inc Internal Medicine Current Accepting new patients
Saint Thomas Medical Partners Internal Medicine CurrentSince May 13, 2014 Accepting new patients
University Health System Inc CurrentSince Nov 1, 2022 Accepting new patients
Medical Faculty Associates, Inc Internal Medicine CurrentSince Mar 6, 2020 Accepting new patients
Saint Thomas Medical Partners CurrentSince May 13, 2014 Accepting new patients
University Health System, Inc Hospice and Palliative Medicine CurrentSince Nov 1, 2022 Accepting new patients

Locations

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

4220 Harding Pike
Ste 500
Nashville, TN 37205
Phone (615) 222-2111

300 20th Ave N
Fl 9
Nashville, TN 37203

4230 Harding Pike
Ste 450
Nashville, TN 37205
Phone (615) 222-3945

Interoperability endpoints

  • Direct secure messaging: ejackson19647@gwmfa.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1730323296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-741-2191",
            "fax_number": "202-741-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-715-4337",
            "fax_number": "202-741-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ERIN",
        "middle_name": "W.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "TN",
            "license": "49778",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "49778",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "IL",
            "license": "036.139904",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "49778",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101253099",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01216006",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100241590",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1531862",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6010875",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.