Jane E Jackson, M.D.

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

D0028973 Issued in MD

Practice address

3512 Sandy CT
Kensington, MD 20895-1420

Phone

(301) 466-2562

Fax

(301) 949-9666

NPI assigned

May 17, 2007

Sex

Female

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1982811709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 SANDY CT",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208951420",
            "telephone_number": "301-466-2562",
            "fax_number": "301-949-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 SANDY CT",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208951420",
            "telephone_number": "301-466-2562",
            "fax_number": "301-949-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JANE",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "MD",
            "license": "D0028973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "385639",
            "identifier": "MAMSI MAPSI",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "K1240001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "343BJE",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alin Ionescu, MD
• Philip Iorianni, M.D.
• Ilan Irony, M.D.
• Nikhila Iruku, D.O
• Amanda L. Irving, MS, OTR/L
• Lyndsay Jarnagin, COTA/L
• Patricia Jo Jaskiewicz, P.T.
• Alexis Jefferson
• Abidemi Jegede
• Megan Eileen Jillella, MS, OTR/L

• Prescribing (Medical) Psychologist in Kensington, MD
• Providers in Kensington, MD by specialty
• Prescribing (Medical) Psychologist in Maryland

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.