James Richard Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04123 Issued in TX

Practice address

3403 S Padre Island Dr Ste 301
Corpus Christi, TX 78415-2925

Phone

(361) 445-3969

Fax

(361) 445-3970

NPI assigned

Jan 24, 2007

Last updated

Oct 21, 2015By the provider in NPPES

Sex

Male

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 TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay Area Psychiatry Services PCGroup PAC ID 2860885282, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Bay Area Psychiatry Services PC

  • Psychiatry Physician
  • Corpus Christi, TX
  • NPI 1235898701
  Medicare reassignment Care Compare group
• Psychiatric Consulting Services

  • Psychiatry Physician
  • Corpus Christi, TX
  • NPI 1134164627
  Medicare reassignment
• Elite Performance, Inc.

  dba Elite Performance Physical Therapy & Pain Center

  • Physical Therapist
  • Harlingen, TX
  • NPI 1336458546
  NPD (past)
• Mid America Surgical Associates

  • Surgery Physician
  • Wichita, KS
  • NPI 1710948906
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1871648253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13310 LEOPARD ST STE 6",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78410",
            "telephone_number": "361-241-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3403 S PADRE ISLAND DR STE 301",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784152925",
            "telephone_number": "361-445-3969",
            "fax_number": "361-445-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JAMES",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Jack
• Brittany Jackowiak, PHARMD
• Jackson Chen, MD, PA
• Bria Jackson
• Donna G Jackson, FNP MSN
• Joel Jackson, LPC,CPO
• Leah Jackson, PTA
• Paul Jackson, DO
• Phillip Jackson, M.D.
• Taylor Catherine Jackson

• Physician Assistant in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.