Individual provider Active NPI

Sheila L. White-Jackson, MD

Pediatrics Physician
Dallas, TX

National Provider Identifier

1801871041

Registry record updated Feb 19, 2013

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices1
NPI Registry JSON
Other providers in Dallas, TX
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Pediatrics PhysicianTaxonomy code 208000000X
License: H6982 Issued in TX
Practice address: 3310 Live Oak St
Youth and Family Center
Dallas, TX 75204-6153
Phone: (214) 266-1257
NPI assigned: Dec 9, 2005
Sex: Female
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)	Code	License	State	Primary
Pediatrics Physician	208000000X	H6982	TX	Primary

Addresses

Primary practice location

3310 Live Oak St
Youth and Family Center
Dallas, TX 75204-6153

Mailing address

PO Box 660599
Dallas, TX 75266-0599

Other identifiers 24

Identifier	Type	State	Issuer
139505514	Medicaid	TX
139505522	Medicaid	TX
87W595	Other	TX	BLUE CROSS BLUE SHIELD
139505530	Medicaid	TX
139505502	Medicaid	TX
139505508	Medicaid	TX
139505529	Medicaid	TX
139505531	Medicaid	TX
139505501	Medicaid	TX
139505505	Medicaid	TX
139505511	Medicaid	TX
139505516	Medicaid	TX
139505509	Medicaid	TX
139505507	Medicaid	TX
139505523	Medicaid	TX
139505527	Medicaid	TX
139505506	Medicaid	TX
139505525	Medicaid	TX
139505504	Medicaid	TX
139505515	Medicaid	TX
139505517	Medicaid	TX
139505526	Medicaid	TX
139505521	Medicaid	TX
139505528	Medicaid	TX

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Enrolled
Credentials: Doctor of Medicine

Practice roles

Organization	Specialty	Status	New patients
Acs Primary Care Physicians Southwest, PA		Past	Accepting new patients

Interoperability endpoints

Direct secure messaging: swhitejackson22198@direct.phhs.org

Organizations & group practices 1

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.

Acs Primary Care Physicians Southwest, PA
- Emergency Medicine Physician
- Gainesville, TX
- NPI 1538101019
NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1801871041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 LIVE OAK ST",
            "address_2": "YOUTH AND FAMILY CENTER",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046153",
            "telephone_number": "214-266-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE-JACKSON",
        "first_name": "SHEILA",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H6982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505514",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505522",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "87W595",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505530",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505508",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505529",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505531",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505505",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505511",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505516",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505509",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505507",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505523",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505527",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505506",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505525",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505504",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505515",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505517",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505526",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505521",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139505528",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.