Jessica Jackson, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

00242 Issued in KY

Practice address

2315 Green Valley Rd Ste 200
New Albany, IN 47150-4690

Phone

(502) 558-0194

NPI assigned

Jun 8, 2006

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ansert Foot and Ankle Center P.S.C.Group PAC ID 4385672567, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

39.13 of 100Reported as group

Quality

69.31

Improvement activities

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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 and National Provider Directory roles.

• Ansert Foot & Ankle Center P.S.C.

  • Foot & Ankle Surgery Podiatrist
  • New Albany, IN
  • NPI 1003032723

  KY

  Medicare reassignment Care Compare group NPD
• New Source Medical, LLC

  • Podiatrist
  • Louisville, KY
  • NPI 1700425816
  Medicare reassignment
• Foot Doctors PSC

  • Foot & Ankle Surgery Podiatrist
  • Louisville, KY
  • NPI 1245390319
  NPD (past)
• Tipton & Unroe, PSC

  • Foot & Ankle Surgery Podiatrist
  • Louisville, KY
  • NPI 1235185489
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1912947631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15014 BIRCHAM RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402454104",
            "telephone_number": "502-558-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 GREEN VALLEY RD STE 200",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504690",
            "telephone_number": "502-558-0194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15014 Bircham Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402454104",
            "country_code": "US",
            "telephone_number": "502-558-0194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "KY",
            "license": "00242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80002421",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200279930",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00696482",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J Michael Williams DMD LLC
• Abdul Jabbar, MD
• Derrick Jack, LCSW
• Kimberly Latrice Jackson-Grundy, PHARMD
• Hannah Jordan Jackson, DMD
• Nicole Jackson
• Regina Jackson
• Jacque Deshay Young, PLLC
• Cara Harris James, D.M.D
• Dawne Michelle James, LCSW

• Podiatrist in New Albany, IN
• Providers in New Albany, IN by specialty
• Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.