Gregory M Jackson, MD, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GREGORY M JACKSON, MD, PA

Practice address

4220 McCullough Ave
San Antonio, TX 78212-1910

Phone

(210) 829-0700

Fax

(210) 829-0714

NPI assigned

Jan 31, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Cheryl M Jackson

Title

Office Manager

Phone

(210) 829-0700

Specialties & licenses 1

Addresses

Other names 1

• GREGORY M JACKSON, MD, PA Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory Mann Jackson, M.D.

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1184738825
  Medicare reassignment NPD
• Sharon Morgan Acker

  • Registered Nurse
  • San Antonio, TX
  • NPI 1861369902
  NPD
• Anna Cavazos Tobon, M.D.

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1619081361
  NPD (past)
• Julia Marie Jensen, DO

  • Sports Medicine (Family Medicine) Physician
  • Boise, ID
  • NPI 1003819509
  NPD (past)

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290384000000",
    "number": "1861670994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 MCCULLOUGH AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782121910",
            "telephone_number": "210-829-0700",
            "fax_number": "210-829-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 MCCULLOUGH AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782121910",
            "telephone_number": "210-829-0700",
            "fax_number": "210-829-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY M JACKSON, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2010-11-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "210-829-0700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREGORY M JACKSON, MD, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra D Greer, RN
• Alessandro Gregorat
• Gregory a. Osborne DDS PA
• Gregory a. Osborne DDS PA
• Gregory D Ales DO PA
• Alisa M Gregory, ACNP
• Holly Jean Gregory, D.D.S.
• Jessica Ann Gregory, CPM, LM
• Michelle Gregory
• Sharon Loverne Gregory, LPC

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.