Markus Jackson MD Inc

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

MARKUS JACKSON MD INC

Practice address

4016 Dale Rd
Modesto, CA 95356-9268

Phone

(706) 288-8683

NPI assigned

May 1, 2020

Last updated

May 1, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Markus R Jackson, MDNPI 1548656937

Title

President

Phone

(706) 288-8683

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Markus Jackson, M.D.

  • Interventional Pain Medicine Physician
  • Modesto, CA
  • NPI 1548656937
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588291200000",
    "number": "1770104606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 37TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171302",
            "telephone_number": "706-288-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 DALE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569268",
            "telephone_number": "706-288-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARKUS JACKSON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-01",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MARKUS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-288-8683",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark T. Fahlen, MD, Inc. a Professional Medical Corporation
• Arletha Vondell Mark
• Janel Mark
• Timothy Markham
• Breanne L. Markowitz, DNP, PMHNP-BC, RN
• Briana Delayne Marlett
• Cassandra Marlow
• Onastacia Nicole Marlow
• Samantha R Marmolejo
• Nirmala Jyothi Marneni, DDS

• Pain Medicine (Anesthesiology) Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.