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JARED ANDREW JACKSON MD
NPI 1043891724
Student in an Organized Health Care Education/Training Program in Myrtle Beach, SC

Active since April 15, 2021
809 82ND PARKWAY, GME OFFICE - GENERAL SURGERY, MYRTLE BEACH, SC 29572(843) 692-1595(843) 692-1122 Get Directions Write a Review

NPPES record last updated: April 15, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jared Andrew Jackson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JARED ANDREW JACKSON MD (NPI 1043891724) is an individual student in an organized health care education/training program in Myrtle Beach, South Carolina and active in the NPI registry since April 2021.

NPPES Registry Identity

NPI1043891724
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJARED ANDREW JACKSONCredential: MD
Location Address809 82ND PARKWAY, GME OFFICE - GENERAL SURGERYMyrtle Beach, SC 29572
Mailing Address809 82nd Parkway, Gme Office - General SurgeryMyrtle Beach, SC 29572 · (843) 692-1595 · Fax (843) 692-1122
Phone(843) 692-1595
Fax(843) 692-1122
Sole ProprietorYes
Enumeration DateApril 15, 2021
NPPES CertifiedMarch 23, 2021
✔ NPI 1043891724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
809 82ND PARKWAY, Myrtle Beach, SC 29572
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Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MOHAMED MEDHAT M FARIS MD
Internal Medicine
809 82ND PARKWAY
MYRTLE BEACH, SC 29572
Horry County (843) 692-1118
MS. DEVI SINGH MAHADEO M.D.
Student in an Organized Health Care Education/Training Program
809 82ND PARKWAY
MYRTLE BEACH, SC 29572
Horry County (843) 692-3497
GRAND STRAND REGIONAL MEDICAL CENTER LLC
General Acute Care Hospital
809 82ND PARKWAY
MYRLTE BEACH, SC 29572
Horry County (843) 692-1000
THOMAS JUSTIN THORNTON DO
Emergency Medicine
809 82ND PARKWAY
MYRTLE BEACH, SC 29572
Horry County (843) 692-3499
DR. EVELYN NWANGULOR OGBOMOH MD
Student in an Organized Health Care Education/Training Program
809 82ND PARKWAY
MYRTLE BEACH, SC 29572
Horry County (843) 692-3497
DR. JONATHAN LEGGETT D.O
Emergency Medicine
809 82ND PARKWAY, GRAND STRAND MEDICAL CENTER/ GME OFFICE
MYRTLE BEACH, SC 29572
Horry County (843) 692-1752
MR. ASFAWOSSEN B ASFAW MD
Pediatrics (Pediatric Critical Care Medicine)
809 82ND PARKWAY, GRAND STAND REGIONAL MEDICAL CENTER
MYRTLE BEACH, SC 29572
Horry County (843) 692-1750
MS. CAROLINE MARIE CUTLER MD
Student in an Organized Health Care Education/Training Program
809 82ND PARKWAY
MYRTLE BEACH, SC 29572
Horry County (843) 692-1118

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jared Jackson's NPI number?

The NPI number for Jared Jackson is 1043891724. It was assigned to this individual provider in the NPPES registry on April 15, 2021.

Where is Jared Jackson located?

Jared Jackson practices at 809 82nd Parkway Gme Office - General Surgery, Myrtle Beach, SC 29572. The listed phone number is (843) 692-1595.

What is Jared Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Jared Jackson was last updated on April 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.