Cynthia Darleen Jackson, PH.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

3104 Issued in TN

Practice address

1916 Patterson St
Ste 504
Nashville, TN 37203-2120

Phone

(615) 977-8779

Fax

(615) 982-6932

NPI assigned

Dec 5, 2007

Last updated

Dec 27, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Matthew Walker Comprehensive Health Center, IncGroup PAC ID 4082691456, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cynthia.jacksonphd.p1@direct.mwchc.nextgenshare.com

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.

• Matthew Walker Comprehensive Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Nashville, TN
  • NPI 1356405278
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1730361312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 PATTERSON ST",
            "address_2": "STE 504",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032120",
            "telephone_number": "615-977-8779",
            "fax_number": "615-982-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 PATTERSON ST",
            "address_2": "STE 504",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032120",
            "telephone_number": "615-977-8779",
            "fax_number": "615-982-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CYNTHIA",
        "middle_name": "DARLEEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "3104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benita S. Jackson, D.D.S.
• Catherine Patricia Jackson, OTD, MSOT, OTR/L
• Chasity Jackson, RN
• Christia Jackson
• Ciara D. Jackson
• Daejah Jackson
• Danielle Jackson, BS
• Danyell Janee Jackson
• Diana Jackson, RN
• Dion Shawnta Jackson

• Specialist in Nashville, TN
• Providers in Nashville, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.