Alexis Joan Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9793 Issued in GA

Practice address

303 Harris Industrial Blvd Ste 3
Vidalia, GA 30474-8854

Phone

(912) 537-9355

Fax

(912) 335-4804

NPI assigned

Jun 4, 2020

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 names 1

• Lexi Joan Jackson Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Candler Medical Oncology Practice LLCGroup PAC ID 2860717089, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Candler Hospital Hospital, Savannah, GA, CCN 110024

Merit-based Incentive Payment System (MIPS)

Final score

69.81 of 100Reported as group

Quality

58.86

Promoting interoperability

53

Improvement activities

40

Cost

70.07

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Candler Medical Oncology Practice, LLC

  • Hematology & Oncology Physician
  • Savannah, GA
  • NPI 1003217712
  Medicare reassignment Care Compare group
• Effingham Physician Practices, LLC

  • Hematology & Oncology Physician
  • Springfield, GA
  • NPI 1477908788
  Medicare reassignment
• Candler Medical Oncology Practice, LLC

  • Hematology & Oncology Physician
  • Bluffton, SC
  • NPI 1376179960
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Candler Hospital Incorporated

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1275527889
  Care Compare affiliation

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1962026013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 E 50TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314044021",
            "telephone_number": "904-704-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 HARRIS INDUSTRIAL BLVD STE 3",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748854",
            "telephone_number": "912-537-9355",
            "fax_number": "912-335-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALEXIS",
        "middle_name": "JOAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jackson@vpc.chartperfect.phimailbox.com",
            "affiliation": "N",
            "endpointDescription": "MD portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "303 Harris Industrial Blvd Ste 3",
            "city": "Vidalia",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304748854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LEXI",
            "last_name": "JACKSON",
            "middle_name": "JOAN",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physician Assistant in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.