David Spencer Jackson, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

D35217 Issued in MD

Practice address

11055 Little Patuxent Pkwy
Suite 205
Columbia, MD 21044-2896

Phone

(410) 740-0789

Fax

(410) 740-7024

NPI assigned

Aug 10, 2005

Sex

Male

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 10

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

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Icahn School of Medicine at Mount Sinai, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maryland Primary Care Physicians, LLCGroup PAC ID 8729981832, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johns Hopkins Howard County Medical Center Hospital, Columbia, MD, CCN 210048

Merit-based Incentive Payment System (MIPS)

Final score

87.36 of 100Reported as group

Quality

79.93

Promoting interoperability

100

Improvement activities

40

Cost

77.92

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: djackson50113@direct.hopkinsmedicine.org

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.

• Maryland Primary Care Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Annapolis, MD
  • NPI 1083667067
  Medicare reassignment Care Compare group NPD
• Maryland Primary Care Physicians, LLC

  • Primary Care Clinic/Center
  • Columbia, MD
  • NPI 1245052281
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Howard County General Hospital, Inc,

  • General Acute Care Hospital
  • Columbia, MD
  • NPI 1144291899
  Care Compare affiliation

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1891796900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 BUCKINGHAM BLVD STE 220",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210763210",
            "telephone_number": "410-729-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11055 LITTLE PATUXENT PKWY",
            "address_2": "SUITE 205",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442896",
            "telephone_number": "410-740-0789",
            "fax_number": "410-740-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DAVID",
        "middle_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "D35217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD RENDERING",
            "identifier": "398140-03",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA FEE FOR SERVICE",
            "identifier": "4238639",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MPOS",
            "identifier": "P528953",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CAPITATED",
            "identifier": "0477972",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "478471500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "060041579",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI SPECIALIST",
            "identifier": "318934",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECHOICE",
            "identifier": "3509-0006",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JHHC PROVIDER NUMBER",
            "identifier": "018410",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "0149212",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aisha Nafisatu Jabbie
• Khadijatu Kubura Jabbie
• Jordan Jayne Jachimowicz
• Chantell Jackson
• Cherissa Jackson, RN
• Deborah Jackson, CRNP
• Ericka Alyce Jackson, RN
• Jia Jackson
• Jodeci Jackson
• Joshue Jackson

• Cardiovascular Disease Physician in Columbia, MD
• Providers in Columbia, MD by specialty
• Cardiovascular Disease Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.