Terri D. Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00941 Issued in TX

Practice address

3310 Live Oak St
Youth & Family Center
Dallas, TX 75204-6153

Phone

(214) 266-1257

Fax

(214) 266-1258

NPI assigned

Aug 1, 2005

Sex

Female

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 4

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

95.1 of 100Reported as group

Quality

88.97

Promoting interoperability

79

Improvement activities

40

Cost

83.75

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjackson22274@direct.phhs.org

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.

• Dallas County Hospital District

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1649278995
  Medicare reassignment
• Dallas County Hospital District

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1235864026
  NPD
• Dallas County Hospital District

  • Women's Health Nurse Practitioner
  • Dallas, TX
  • NPI 1558035188
  NPD
• Vickery Health Center

  • Psychologist
  • Dallas, TX
  • NPI 1831166446
  NPD (past)

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1750381752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 LIVE OAK ST",
            "address_2": "YOUTH & FAMILY CENTER",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046153",
            "telephone_number": "214-266-1257",
            "fax_number": "214-266-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TERRI",
        "middle_name": "D.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-01",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179959501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179959502",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8N4447",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00051267",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamara Jackson
• Tara Renae Jackson, CRNA
• Tawanna Jackson
• Te'Ja Jamise Jackson
• Tedra Nikia Jackson
• Trenel Shundrae Jackson, APRN, FNP-BC
• Tyneshea Jackson
• Warren T Jackson, PHD
• William J Jackson, M.D.
• William Kenneth Jackson, DDS

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.