Elmer H Jackson, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

15266 Issued in KY

Practice address

217 S 3Rd St
Danville, KY 40422-1823

Phone

(859) 239-1220

Fax

(859) 239-6719

NPI assigned

Apr 8, 2006

Last updated

Nov 30, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Danville Radiology Associates PSC

  • Diagnostic Radiology Physician
  • Danville, KY
  • NPI 1083676902
  NPD (past)

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1851354245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3361",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425643361",
            "telephone_number": "865-766-8818",
            "fax_number": "865-766-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 S 3RD ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404221823",
            "telephone_number": "859-239-1220",
            "fax_number": "859-239-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELMER",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "15266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64152663",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "000000063422",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Insight Behavioral Health Associates
• Sarah J Iqbal, DMD
• Isaiah House Inc (Isaiah House Outpatient Services)
• Isaiah House Inc (Real Health Primary Care)
• Jackson Pain Management Clinic, PLLC
• Richard G Jackson Jr., M.D,
• James Duncan MD Consulting Service PLLC
• James Medical Equipment, LTD.
• Teodoro Jimenez, MD
• Erika B. Johnson, TCM

• Diagnostic Radiology Physician in Danville, KY
• Providers in Danville, KY by specialty
• Diagnostic Radiology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.