Tracey Ann Jackson, LBSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1547 Parkway Ste 100
Greenwood, SC 29646-4081

Phone

(864) 229-7120

NPI assigned

Oct 2, 2008

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.7 of 100Reported as apm

Quality

89.4

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Self Medical Group

  • Surgery Physician
  • Greenwood, SC
  • NPI 1982836847
  Medicare reassignment Care Compare group NPD
• Self Medical Group

  • Psychiatry Physician
  • Greenwood, SC
  • NPI 1205141371
  NPD
• Self Medical Group

  • Diagnostic Radiology Physician
  • Greenwood, SC
  • NPI 1659839694
  NPD

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1861643389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 CEDAR SPGS S",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "296206246",
            "telephone_number": "864-446-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1547 PARKWAY STE 100",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464081",
            "telephone_number": "864-229-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TRACEY",
        "middle_name": "ANN",
        "credential": "LBSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421504",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrienne Jackson
• Amy R Jackson
• Christa Jackson
• Michelle M Jackson
• Tabitha Jackson
• Ashley Jacobs, PHARMD
• Jessica Faith Sara Jacobs, LPC
• Jordan James, PTA
• Tamera Janelle James, M.A.
• Walter Ennis James III, MD

• Mental Health Counselor in Greenwood, SC
• Providers in Greenwood, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.