Active NPI
Robert Evan Jackson, MD
- Internal Medicine Physician
- Houston, TX
National Provider Identifier
1841296001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G2602
- Practice address
- 6550 Fannin Street
Suite 2323
Houston, TX 77030 - Phone
- (713) 791-9305
- Fax
- (713) 791-9306
- NPI assigned
- Jun 22, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G2602 | TX | Primary |
Addresses
Primary practice location
6550 Fannin Street
Suite 2323
Houston, TX 77030
Mailing address
6550 Fannin Street
Suite 2323
Houston, TX 77030
Phone (713) 791-9305
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Previously, effective Aug 3, 2016 through Aug 3, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associates in Medicine, P.a. | Internal Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/21774/brand/1/csg/1/fhir/r4
- robert.jackson.2@21661.direct.athenahealth.com
- rjackson21359@directhoustonmethodist.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.
-
- Internal Medicine Physician
- Houston, TX
- NPI 1457411225
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701302400000",
"number": "1841296001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6550 FANNIN STREET",
"address_2": "SUITE 2323",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77030",
"telephone_number": "713-791-9305",
"fax_number": "713-790-9306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6550 FANNIN STREET",
"address_2": "SUITE 2323",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77030",
"telephone_number": "713-791-9305",
"fax_number": "713-791-9306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ROBERT",
"middle_name": "EVAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-22",
"last_updated": "2023-11-30",
"certification_date": "2023-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "G2602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.