Cheryl Jackson, MD

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

94-00282 Issued in NC

Practice address

101 Manning Dr
Chapel Hill, NC 27599-0001

Phone

(919) 966-8596

Fax

(919) 843-5515

NPI assigned

Oct 13, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjackson12301@direct.unc.nchie.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.

• University of North Carolina at Chapel Hill

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200

  Pediatrics

  Medicare reassignment NPD
• North Carolina Center for Dermatology PA

  • Dermatology Physician
  • Durham, NC
  • NPI 1326101262
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1831289586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 W FRANKLIN ST",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275162539",
            "telephone_number": "919-966-8596",
            "fax_number": "919-843-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275990001",
            "telephone_number": "919-966-8596",
            "fax_number": "919-843-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHERYL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "94-00282",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NC",
            "license": "94-00282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891071X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Jacks, PH.D.
• Jackson Psychological Assessment and Therapeutic Services
• Lisa Anne Jackson-Moore, MD
• Arthur Jackson
• Caroline Jackson, RBT
• Christina Bonebreak Jackson, DMD
• Corrie Nicole Cleo Jackson, MD
• Gabrielle Jackson, DDS
• Hannah Rachael Jackson
• Kimberly Dawn Jackson, MPT

• Pediatric Emergency Medicine (Pediatrics) Physician in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.