Danielle Margaret Colette Jackson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

19594 Issued in MN

Practice address

1575 Beam Ave
Emergency Department
Maplewood, MN 55109-1126

Phone

(651) 232-7000

NPI assigned

Feb 21, 2008

Last updated

Feb 19, 2010By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medicine Services of TN, PC

  • Emergency Medicine Physician
  • Nashville, TN
  • NPI 1720785884
  Medicare reassignment NPD

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266537600000",
    "number": "1750550919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 BEAM AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091126",
            "telephone_number": "651-232-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 BEAM AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091126",
            "telephone_number": "651-232-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DANIELLE",
        "middle_name": "MARGARET COLETTE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2010-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "19594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENCY PERMIT NUMBER",
            "identifier": "19594",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nadeem Iqbal, M.D.
• Isd 622 Gladstone Meals on Wheels
• Alexander Ivaskovic, MD
• Kathleen Ann Iverson, LDH
• Sanaz Jabbari, DDS
• Katrina Margaret Jackson, CNP
• Thomas R. Jacques, M.D.
• Raeann Jaeb, OTR/L
• Laura Lea Jaeger, DPT
• Michael J Jaeger, PA-C

• Emergency Medicine Physician in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Emergency Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.