Joyce Jacquetta Jackson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R109047 Issued in MD

Practice address

3450 Old Washington Road
Suite 202
Waldorf, MD 20602-3248

Phone

(301) 645-3590

Fax

(301) 705-1941

NPI assigned

Feb 14, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC, VA3 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 3

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 33)

Interoperability endpoints

• Direct secure messaging: joyce.jacksonnp.p3@direct.cvr.nextgenshare.com

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.

• Belmont Surgery Center, L.L.C.

  • Ambulatory Surgical Clinic/Center
  • Chevy Chase, MD
  • NPI 1528386497

  DC

  Medicare reassignment NPD
• Center for Vein Restoration MD LLC

  • Vascular Surgery Physician
  • Greenbelt, MD
  • NPI 1487772349

  DC, VA

  Medicare reassignment NPD
• Center for Vein Restoration MD LLC

  • Vascular Surgery Physician
  • Greenbelt, MD
  • NPI 1770741753
  Medicare reassignment NPD
• Center for Vein Restoration MD LLC

  • Vascular Surgery Physician
  • Prince Frederick, MD
  • NPI 1912729211
  NPD

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1932377702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OLD WASHINGTON ROAD",
            "address_2": "SUITE 202",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023248",
            "telephone_number": "301-645-3590",
            "fax_number": "301-705-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 OLD WASHINGTON ROAD",
            "address_2": "SUITE 202",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023248",
            "telephone_number": "301-645-3590",
            "fax_number": "301-705-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOYCE",
        "middle_name": "JACQUETTA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R109047",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024167148",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "622905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Jackson
• Brendalan Jackson, LCSW
• Crystal I Jackson, LGSW-G
• Dainty J Jackson, D. O.
• Gianna Latrice Jackson, GMFT
• Nathaniel Jackson Jr.
• Janelle Adrienne Jacobs
• Geraldine Jessica Jaganathan, PTA
• Amin Jahedi
• Jameel Care LLC

• Nurse Practitioner in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; 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.