Ryan Jackson, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

9344119-1205 Issued in UT

Practice address

1380 E Medical Center Dr
St George, UT 84790-2123

Phone

(435) 634-4000

Fax

(678) 285-6777

NPI assigned

Mar 30, 2007

Last updated

Aug 18, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, MT, WY3 enrollments

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 3

Specialty

Anesthesiology

Education

University of Utah School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain West Anesthesia LLCGroup PAC ID 9032018502, 267 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. George Regional Hospital Hospital, St George, UT, CCN 460021

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.

• Mountain West Anesthesia LLC

  • Anesthesiology Physician
  • Lehi, UT
  • NPI 1558391763
  Medicare reassignment Care Compare group NPD
• Billings Clinic

  • Emergency Care Clinic/Center
  • Billings, MT
  • NPI 1326104845
  Medicare reassignment NPD
• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  Medicare reassignment NPD
• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Family Medicine Physician
  • Afton, WY
  • NPI 1730132523
  Medicare reassignment NPD
• Billings Clinic

  dba Billings Clinic Heights

  • Family Medicine Physician
  • Billings, MT
  • NPI 1033164447
  NPD
• Billings Clinic

  • General Practice Physician
  • Billings, MT
  • NPI 1376598714

  Family Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services, Inc.

  dba Intermountain Health St. George Regional Hospital

  • General Acute Care Hospital
  • St George, UT
  • NPI 1366452880
  Care Compare affiliation

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1770603102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3570",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103570",
            "telephone_number": "801-432-2600",
            "fax_number": "678-285-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 E MEDICAL CENTER DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902123",
            "telephone_number": "435-634-4000",
            "fax_number": "678-285-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301087396",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "9344119-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernestine Jackson
• Jazmine Jackson
• Jennifer Marie Jackson
• Kelly James Jackson, PT
• Lara Cameron Jackson
• Savanah Jackson
• Shanna Jackson
• Stephen Michael Jackson, DMD
• Sylvia Morgan Jackson
• Talia Jackson

• Anesthesiology Physician in St George, UT
• Providers in St George, UT by specialty
• Anesthesiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.