Jarrod B. Adkison, M.D.

Individual provider Active NPI Radiation Oncology Physician · Dothan, AL

NPI 1790719318 · NPPES record last updated Jan 28, 2019

Key facts

NPI
1790719318
Entity type
Individual (NPI type 1)
Primary specialty
Radiation Oncology Physician 2085R0001X
License
MD.29203 (AL)
Practice address
1108 Ross Clark Circle
Southeast Alabama Medical Center, Radiation Oncology
Dothan, AL 36301-3022
Phone
(334) 793-8081
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

Medicare Care Compare profile

Specialty
Radiation Oncology
Education
University of South Alabama College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 793-8080

Hospital & facility affiliations

  • Southeast Health Medical Center Hospital · Dothan, AL · CCN 010001
  • Flowers Hospital Hospital · Dothan, AL · CCN 010055
  • Medical Center Enterprise Hospital · Enterprise, AL · CCN 010049

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20101008000048 AL Practitioner - Radiation Oncology 0042402083 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.29203ALMDRadiation Oncology Physician
ME 106420FLMDRadiation Oncology Physician
1760WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wiregrass Radiation Oncology PC Radiation Oncology Current
since Mar 26, 2010
Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1108 Ross Clark Cir
Ste 100
Dothan, AL 36301

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 1760 WI
Specialist 174400000X 29203 AL
Radiation Oncology Physician 2085R0001X ME 106420 FL
Radiation Oncology Physician 2085R0001X MD.29203 AL Yes

Addresses

Primary practice location

1108 Ross Clark Circle
Southeast Alabama Medical Center, Radiation Oncology
Dothan, AL 36301-3022

Mailing address

P.O. Box 5609
Southeast Alabama Medical Center, Radiation Oncology
Dothan, AL 36302-5609
Phone (334) 793-8081

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 28, 2019.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1790719318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5609",
            "address_2": "SOUTHEAST ALABAMA MEDICAL CENTER, RADIATION ONCOLOGY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363025609",
            "telephone_number": "334-793-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIRCLE",
            "address_2": "SOUTHEAST ALABAMA MEDICAL CENTER, RADIATION ONCOLOGY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-793-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADKISON",
        "first_name": "JARROD",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WI",
            "license": "1760",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "29203",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME 106420",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "AL",
            "license": "MD.29203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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Sources for this page

Verify at the official NPI Registry.