G Hagan Jackson MD PC

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

Last updated

Nov 5, 2013By 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

Dr. George Hagan Jackson, MDNPI 1124369863

Title

Owner/Provider

Phone

(804) 588-6993

Specialties & licenses 1

Addresses

Interoperability endpoints

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

Practitioners 1

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.

• George Hagan Jackson, M.D.

  • Neurology Physician
  • Glen Allen, VA
  • NPI 1124369863
  Authorized official Same address or phone

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": []
}

• Stefanie Froelich
• Caycee Frost, PA-C
• Emily W Frost, PMHNP-BC
• Full Moon Medical Transportation LLC
• Kelli Funkhouser, MS, PT
• Mona Gaafar
• Joseph Salo Galeski III, M.D.
• Jadig Garcia, PHD, LCP
• Kristine Ashley Garcia, PMHNP-BC
• Algin Baylor Garrett, M.D.

• Neurology Physician in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Neurology Physician in Virginia

• 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.