Kim Ngan Thi Jackson, MD

Primary specialty

Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X

License

E13055 Issued in AR

Practice address

18 Corporate Hill Dr Ste 110
Little Rock, AR 72205-4565

Phone

(501) 224-1156

Fax

(501) 223-2625

NPI assigned

Apr 13, 2015

Sex

Female

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 AR

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

Allergy/Immunology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Little Rock Allergy and Asthma Clinic PAGroup PAC ID 1658383633, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Regional Medical Center Hospital, Pine Bluff, AR, CCN 040071

Merit-based Incentive Payment System (MIPS)

Final score

75.5 of 100Reported as group

Quality

50.65

Improvement activities

40

Cost

84.14

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Little Rock Allergy & Asthma Clinic PA

  • Allergy & Immunology Physician
  • Little Rock, AR
  • NPI 1154360576
  Medicare reassignment Care Compare group

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

• Jefferson Hospital Association Inc

  • General Acute Care Hospital
  • Pine Bluff, AR
  • NPI 1710931985
  Care Compare affiliation

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1902292329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 CORPORATE HILL DR STE 110",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054565",
            "telephone_number": "501-978-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CORPORATE HILL DR STE 110",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054565",
            "telephone_number": "501-224-1156",
            "fax_number": "501-223-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KIM NGAN",
        "middle_name": "THI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "AR",
            "license": "E13055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kanesha Jackson
• Kara Jackson, DPT
• Katrina A Jackson, CRNA
• Kelly Elise Jackson, COTA/L
• Kenley Brooke Jackson, PT, DPT
• Kimberly Ann Jackson, N/A ...NONE
• Kyle Everett Jackson, MD
• Lanelle Jackson, APN
• Laportia Jacqueline Jackson, LPC
• Latoya Jackson

• Allergy & Immunology (Internal Medicine) Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Allergy & Immunology (Internal Medicine) Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.