Allen B Jackson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

13680 Issued in SC

Practice address

8761 Dorchester Rd Ste 100
North Charleston, SC 29420-7320

Phone

(843) 767-3323

Fax

(843) 767-4252

NPI assigned

Mar 24, 2006

Last updated

Nov 3, 2023By 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• BHG LXXX, LLC

  dba BHG Medical Services - South Carolina

  • Substance Use Disorder Rehabilitation Clinic/Center
  • North Charleston, SC
  • NPI 1659081644

  Multi-Specialty

  Medicare reassignment NPD
• Liberty Doctors LLC

  dba Mackey Family Practice

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1700162203

  Multi-Specialty

  Medicare reassignment NPD
• BHG LXXX, LLC

  dba BHG Medical Services - South Carolina

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Aiken, SC
  • NPI 1518671395
  NPD
• Liberty Doctors, LLC

  dba Mobile Medical Consultants

  • Family Medicine Physician
  • North Charleston, SC
  • NPI 1376854406

  Multi-Specialty

  NPD
• Palmetto Family Medicine and Senior Care, LLC

  • Family Medicine Physician
  • Hartsville, SC
  • NPI 1194122598

  Multi-Specialty

  NPD
• Lowcountry Medical Associates

  dba Moncks Corner Primary Care

  • Internal Medicine Physician
  • Moncks Corner, SC
  • NPI 1790735975
  NPD (past)
• Serio South Carolina, LLC

  • Emergency Medicine Physician
  • Columbia, SC
  • NPI 1699006593

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1902866965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13955",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294223955",
            "telephone_number": "843-764-0770",
            "fax_number": "843-863-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8761 DORCHESTER RD STE 100",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294207320",
            "telephone_number": "843-767-3323",
            "fax_number": "843-767-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALLEN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "SC",
            "license": "13680",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "13680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP6738",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136800",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Irwin, PHARMD
• Jana Isom
• Allison Ivy, RN
• J Taylor Prchal Inc
• J. E. Cauley, DMD, P.C.
• Grasha McLaurin Jackson
• John Jackson, RN
• Johnasia Jackson
• Jonette Ann Jackson
• Matthew Jackson, DPT

• Internal Medicine Physician in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.