Marie C Jackson

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

E15780 Issued in MD

Practice address

2000 W Baltimore St
Baltimore, MD 21223-1558

Phone

(410) 362-3000

NPI assigned

Mar 8, 2006

Last updated

Feb 5, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Emergency Medicine

Education

Un of California, Irvine, College of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physicians SPPSGroup PAC ID 0648594036, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjackson47373@direct.mdmercy.com

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.

• Emergency Physicians SPPS

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1760885958
  Medicare reassignment Care Compare group NPD
• Grace Medical Center, Inc.

  • Mammography Clinic/Center
  • Baltimore, MD
  • NPI 1326629619
  Medicare reassignment NPD
• University of Maryland Midtown Health Inc

  dba University of Maryland Urgent Care

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1710347729
  Medicare reassignment NPD
• Grace Medical Center, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1104151091
  NPD
• Grace Medical Center, Inc.

  dba Department of Anesthesiology

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1306081328
  NPD
• Grace Medical Center, Inc.

  • Basic Emergency Medical Technician
  • Baltimore, MD
  • NPI 1659698124
  NPD (past)
• Grace Medical Center, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1962480772
  NPD (past)
• St Paul Place Specialists Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1497707681

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1871561845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73276",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212733276",
            "telephone_number": "410-362-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BALTIMORE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212231558",
            "telephone_number": "410-362-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARIE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D41734",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "E15780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacy Jackson
• Lauren Samantha Jackson
• Lisa Wilhelm Jackson, MS, RD, LDN, CNSC
• Marcella Jackson, LMSW
• Mariah M Jackson
• Mark Jackson, MD
• Mary Lueben Jackson, PA-C
• Matthew Jackson, D.O.
• Matthew Jackson, MD
• Mia Jackson

• Emergency Medicine Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Emergency Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.