Active NPI
Burke L Jackson, M.D.
- Family Medicine Physician
- Ocala, FL
National Provider Identifier
1821038076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME38870
- Practice address
- 1808 E Silver Springs Blvd
Ocala, FL 34470-6921 - Phone
- (352) 291-5000
- Fax
- (352) 291-5004
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME38870 | FL | Primary |
Addresses
Primary practice location
1808 E Silver Springs Blvd
Ocala, FL 34470-6921
Mailing address
1808 E Silver Springs Blvd
Ocala, FL 34470-6921
Phone (352) 291-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041557001 | Medicaid | FL | |
| 94201 | Other | FL | BLUE CROSS BLUE SHIELD OF FLORIDA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME38870 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Express Care of Belleview, LLC | Family Medicine | Past | Accepting new patients |
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.
-
- Rural Health Clinic/Center
- Belleview, FL
- NPI 1952357519
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455494400000",
"number": "1821038076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 E SILVER SPRINGS BLVD",
"city": "OCALA",
"state": "FL",
"postal_code": "344706921",
"telephone_number": "352-291-5000",
"fax_number": "352-291-5004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 E SILVER SPRINGS BLVD",
"city": "OCALA",
"state": "FL",
"postal_code": "344706921",
"telephone_number": "352-291-5000",
"fax_number": "352-291-5004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "BURKE",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2016-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME38870",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "041557001",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
"identifier": "94201",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocala, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.