NPIMap

Organization Active NPI

G Hagan Jackson MD PC

  • Neurology Physician
  • Glen Allen, VA
National Provider Identifier
1992134423
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0101238219 Issued in VA
Legal business name
G HAGAN JACKSON MD PC
Practice address
5231 Hickory Park Dr
Suite D
Glen Allen, VA 23059-2619
Phone
(804) 588-6993
NPI assigned
Nov 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Authorized official

Name
Dr. George Hagan Jackson, MD
Title
Owner/Provider
Phone
(804) 588-6993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X 0101238219 VA Primary

Addresses

Primary practice location

5231 Hickory Park Dr
Suite D
Glen Allen, VA 23059-2619

Mailing address

PO Box 4319
Glen Allen, VA 23058-4319
Phone (804) 588-6993

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8037/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383609600000",
    "number": "1992134423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4319",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230584319",
            "telephone_number": "804-588-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5231 HICKORY PARK DR",
            "address_2": "SUITE D",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230592619",
            "telephone_number": "804-588-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G HAGAN JACKSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "HAGAN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "804-588-6993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101238219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.