Jodi Jackson

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD419732 Issued in PA

Practice address

8791 Barnes Lake Rd
Ste 202
Irwin, PA 15642-3176

Phone

(724) 864-6834

NPI assigned

May 24, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: jodi.l.jackson@upmcdirect.com

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.

• Children's Community Care

  • Pediatrics Physician
  • Wexford, PA
  • NPI 1659339547
  NPD (past)
• University of Pittsburgh Physicians

  • Diagnostic Radiology Physician
  • Pittsburgh, PA
  • NPI 1285692699
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1750384616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11279 PERRY HWY",
            "address_2": "STE 450",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8791 BARNES LAKE RD",
            "address_2": "STE 202",
            "city": "IRWIN",
            "state": "PA",
            "postal_code": "156423176",
            "telephone_number": "724-864-6834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JODI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD419732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jodi.l.jackson@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Irwin Psychological Services, LLC
• Irwin Volunteer Fire Department (Irwin VFD Ambulance)
• Dennis J Irwin, DC
• Matthew James Irwin, DC
• Lindsay Jack
• Nia Jackson
• Nileina Jackson
• Shannon Jackson
• Anar Jani
• Jeannette Primary Care (Dr's Lipinski and Rathgeb)

• Pediatrics Physician in Irwin, PA
• Providers in Irwin, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.