Patricia Jackson MD, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PATRICIA JACKSON MD, LLC

Practice address

1111 Medical Center Blvd
Suite N408
Marrero, LA 70072

Phone

(504) 349-2908

Fax

(504) 378-0019

NPI assigned

Sep 20, 2006

Last updated

Aug 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James O TheisNPI 1780773440

Title

Authorized Official

Phone

(504) 349-2908

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James O Theis, MD

  • Family Medicine Physician
  • Marrero, LA
  • NPI 1780773440
  Medicare reassignment Care Compare group NPD Authorized official
• Patricia A Jackson, MD

  • Internal Medicine Physician
  • Marrero, LA
  • NPI 1326146036
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1952409567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6019 CONSTANCE ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185806",
            "telephone_number": "504-349-2908",
            "fax_number": "504-378-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE N408",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-2908",
            "fax_number": "504-378-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA JACKSON MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "THEIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "504-349-2908"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Fraser Parrish, RN
• Sebastian Partesotti, M.D.
• Falguni Patel, M.D
• Pathology LLC
• Patricia C Estrada MD, Apmc
• Maria Patterson, BSN, RN
• Paul H Ragas DDS LLC
• Noily Paul III
• Mykera Payne
• Kayla Paynes

• Internal Medicine Physician in Marrero, LA
• Providers in Marrero, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.