Individual provider Active NPI

Marnie Jackson, MD

  • Anesthesiology Physician
  • Rio Hondo, TX
National Provider Identifier
1881805034
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
N0852 Issued in TX
Practice address
606 S Arroyo Blvd, PO Box 529
Rio Hondo, TX 78583-4165
Phone
(956) 226-8389
Fax
(956) 630-6643
NPI assigned
May 26, 2007
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X N0852 TX Primary
Pediatrics Physician 208000000X N0852 TX
Pediatric Anesthesiology Physician 207LP3000X N0852 TX

Addresses

Primary practice location

606 S Arroyo Blvd, PO Box 529
Rio Hondo, TX 78583-4165

Mailing address

606 Arroyo Blvd
Box 529
Rio Hondo, TX 78583-4165
Phone (956) 226-8389

Other identifiers 6

IdentifierTypeStateIssuer
197710005MedicaidTX
8BX291OtherTXBCBS
197710003MedicaidTX
N0852OtherTXSTATE LIC
197710006OtherTXCSHCN
BP1-0018388OtherINSTITUTIONAL PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081103000345 TX Practitioner - AnesthesiologyPractitioner - Pediatric Medicine 0244399434 Reassigns benefits to 2 organizations
I20141216002168 FL Practitioner - Anesthesiology 0244399434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Baylor College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harlingen Anesthesia AssociatesGroup PAC ID 5294637112, 47 clinicians

Practice addresses (Care Compare)

2101 Pease St
Harlingen, TX 78550-8307
Phone (956) 389-2044

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
127663CAMDMarriage & Family Therapist
N0852TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harlingen Anesthesia Associates Anesthesiology CurrentSince May 3, 2021 Accepting new patients
Flamingo Anesthesia Associates Inc Anesthesiology CurrentSince Sep 16, 2019 Accepting new patients
Rio Grande Anesthesia & Pain Medicine Consultants, P.a. Anesthesiology CurrentSince Jan 29, 2024 Accepting new patients
Harlingen Anesthesia Associates Anesthesiology Past Accepting new patients
Pediatric Anesthesia Consultants of San Antonio PLLC Anesthesiology Past Accepting new patients
Texas Institute of Medicine and Surgery Anesthesiology Past Accepting new patients
Rio Grande Anesthesia & Pain Medicine Consultants, P .a. Pediatric Anesthesiology PastSince May 7, 2024 Accepting new patients

Locations

501 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 430-1700

1040 W Jefferson St
Brownsville, TX 78520
Phone (956) 423-4589

1702 N Ed Carey Dr
Harlingen, TX 78550
Phone (956) 423-4589

2101 Pease St
Harlingen, TX 78550
Phone (956) 369-1100

101 E Ridge Rd
McAllen, TX 78503
Phone (956) 632-6000

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1180137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1881805034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 ARROYO BLVD",
            "address_2": "BOX 529",
            "city": "RIO HONDO",
            "state": "TX",
            "postal_code": "785834165",
            "telephone_number": "956-226-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 S ARROYO BLVD, PO BOX 529",
            "city": "RIO HONDO",
            "state": "TX",
            "postal_code": "785834165",
            "telephone_number": "956-226-8389",
            "fax_number": "956-630-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARNIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-26",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "N0852",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N0852",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "N0852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197710005",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8BX291",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197710003",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC",
            "identifier": "N0852",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "197710006",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0018388",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Hondo, TX

Sources for this page

Verify at the official NPI Registry.