Chelsi M Jackson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

P9882 Issued in TX

Practice address

105 Zeid Blvd
Henderson, TX 75652-6070

Phone

(903) 657-7583

Fax

(903) 903-8775

NPI assigned

May 31, 2011

Sex

Female

Sole proprietor

No

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 TX

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

Specialty

Family Practice

Education

University of Texas Medical School at Houston, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Angels Care Home Health Home health agency, Palestine, TX, CCN 458433
• Vitalcaring Group Home health agency, Henderson, TX, CCN 458072
• Accentcare Home Health of Texas Home health agency, Longview, TX, CCN 679090
• Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Ut Health East Texas Henderson Hospital Hospital, Henderson, TX, CCN 450475

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjackson14621@christushealth.direct-ci.net

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.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment Care Compare group NPD
• Mother Frances Hospital Jacksonville

  • Critical Access Hospital
  • Jacksonville, TX
  • NPI 1952306672
  Medicare reassignment NPD
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Trinity Clinic

  • Rural Health Clinic/Center
  • Henderson, TX
  • NPI 1760676613
  NPD (past)

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

• Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1124092036
  Care Compare affiliation
• Henderson Hospital, LLC

  • General Acute Care Hospital
  • Henderson, TX
  • NPI 1326546797
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Northeast Texas Home Health Agency LTD

  • Home Health Agency
  • Henderson, TX
  • NPI 1871632513
  Care Compare affiliation
• Personal Home Healthcare Agency LLC

  • Home Health Agency
  • Palestine, TX
  • NPI 1831194018
  Care Compare affiliation
• Texas Home Health Skilled Services,LP

  • Home Health Agency
  • Longview, TX
  • NPI 1669695722
  Care Compare affiliation

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1811281504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6400",
            "fax_number": "903-877-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ZEID BLVD",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756526070",
            "telephone_number": "903-657-7583",
            "fax_number": "903-903-8775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Zeid Blvd Bldg 2",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "TX",
            "postal_code": "756526070",
            "country_code": "US",
            "telephone_number": "903-315-5612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHELSI",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10041306",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P9882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Marie Ingram, RPH
• J.L. Miguez, Inc.
• Alisa Jackson, PHARMD
• Brent A Jackson, D.D.S.
• Brian Clark Jackson, D.D.S.
• Jalopy Shoppe, Inc.
• Jeff D Miller Investments, LLC
• John T. Melvin, M.D. & Associates
• Mary L. Johnson, MANAGER
• Shannon Johnson

• Family Medicine Physician in Henderson, TX
• Providers in Henderson, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.