Jeffery B. Jackson, M.D.

Primary specialty

Pediatric Hospice and Palliative Medicine PhysicianTaxonomy code 2080H0002X

License

185550-1205 Issued in UT

Practice address

1995 W 9000 S
West Jordan, UT 84088-9345

Phone

(801) 566-9888

Fax

(801) 566-9899

NPI assigned

Apr 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in UT

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

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.

• Biomechanics Institute PLLC

  • Podiatrist
  • West Jordan, UT
  • NPI 1548545338
  NPD (past)
• Department of Pediatrics University of Utah

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1679528715
  NPD (past)
• Southwest Children'S Clinic

  • Specialist
  • West Jordan, UT
  • NPI 1144345737
  NPD (past)

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952363285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889345",
            "telephone_number": "801-566-9888",
            "fax_number": "801-566-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889345",
            "telephone_number": "801-566-9888",
            "fax_number": "801-566-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JEFFERY",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "UT",
            "license": "185550-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT MED",
            "identifier": "107005205101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "QM0000012571",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "12-00098",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "87-0560776",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashlee Isbell
• Tayler Jane Iversen, LCSW
• Shelby Ivory
• Patti Kiyomi Iwamoto, M.S., CCC-A
• J & J Business Ventures, LLC
• Nissa Marie Jackson
• Celena Jacques
• Tanya Jadrich
• Aubree Jameson
• Arlen K Jarrett, MD

• Pediatric Hospice and Palliative Medicine Physician in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Pediatric Hospice and Palliative Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.