Christine Jackson, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

13940 Issued in AZ

Practice address

162 W Central Ave
Eagar, AZ 85925-9707

Phone

(928) 333-1030

Fax

(928) 333-1033

NPI assigned

Dec 2, 2005

Last updated

Jan 4, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Cardiovascular Disease (Cardiology)

Education

University of Arizona College of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White Mountain Regional Medical CenterGroup PAC ID 1951203512, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• White Mountain Regional Medical Center Hospital, Springerville, AZ, CCN 031315
• Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• White Mountain Regional Medical Center

  • Critical Access Hospital
  • Springerville, AZ
  • NPI 1699766592
  Medicare reassignment Care Compare group NPD
• Heart Center of Northeastern Arizona, LLC

  • Interventional Cardiology Physician
  • Show Low, AZ
  • NPI 1619948130

  Cardiovascular Disease

  NPD (past)
• Northern Arizona Heart Center

  • Interventional Cardiology Physician
  • Show Low, AZ
  • NPI 1083685200
  NPD (past)

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

• Summit Healthcare Association

  dba Summit Healthcare Oncology Center

  • Oncology Clinic/Center
  • Show Low, AZ
  • NPI 1083736128

  Hospital

  Care Compare affiliation
• Summit Healthcare Association

  dba Summit Healthcare Regional Medical Center

  • Rural Acute Care Hospital
  • Show Low, AZ
  • NPI 1144209271
  Care Compare affiliation
• Summit Healthcare Medical Associates

  dba Family Medicine at Bison Ranch

  • Rural Health Clinic/Center
  • Overgaard, AZ
  • NPI 1770700767

  Hospital

  Care Compare affiliation
• White Mountain Regional Medical Center

  • Critical Access Hospital
  • Springerville, AZ
  • NPI 1699766592
  Care Compare affiliation

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1861476889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1120",
            "city": "EAGAR",
            "state": "AZ",
            "postal_code": "859251120",
            "telephone_number": "928-333-1030",
            "fax_number": "928-333-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 W CENTRAL AVE",
            "city": "EAGAR",
            "state": "AZ",
            "postal_code": "859259707",
            "telephone_number": "928-333-1030",
            "fax_number": "928-333-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTINE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "13940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reece Kirby Hadlock, PA-C
• Scott R Hamblin, M.D.
• Kayle L Haws, O.D.
• James Heap
• Steven Paul Heap, OD
• Jim W Crosby DDS PC
• La Casa Serena
• Nicholas Talbert Mallory, DMD
• Candice Marissa Matthews, RDH
• Brooke Arlene McCarthy, OTRL

• Cardiovascular Disease Physician in Eagar, AZ
• Providers in Eagar, AZ by specialty
• Cardiovascular Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.