DERRELL GLENN JACKSON PA-C
NPI 1104072297
Physician Assistant in Colonial Heights, VA
NPI Status: Active since August 08, 2008
Contact Information
436 CLAREMONT CT
SUITE 100
COLONIAL HEIGHTS, VA
ZIP 23834
Phone: (804) 526-2121
Fax: (804) 520-2617
- Individual
- Male
- Physician Assistant
About DERRELL JACKSON
This page provides the complete NPI Profile along with additional information for Derrell Jackson, a primary care provider established in Colonial Heights, Virginia with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1104072297 assigned on August 2008. The practitioner's primary taxonomy code is 363A00000X with license number 0110002804 (VA). The provider is registered as an individual and his NPI record was last updated 16 years ago.
- NPI
- 1104072297
- Provider Name
- DERRELL GLENN JACKSON PA-C
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 436 CLAREMONT CT SUITE 100 COLONIAL HEIGHTS, VA 23834
- Location Phone
- (804) 526-2121
- Location Fax
- (804) 520-2617
- Mailing Address
- 205 MISTY RIDGE LN SUFFOLK, VA 23434
- Mailing Phone
- (757) 406-7328
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-08-2008
- Last Update Date
- 05-26-2010
- Code Navigator
A primary care provider (PCP) like Derrell Jackson sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 0110002804
- License State
- VA
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 0110002804 (VA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10040880P | OTHER (01) | VA | OPTIMA |
| P00685057 | OTHER (01) | VA | RR MEDICARE |
| 1104072297 | MEDICAID (05) | VA | |
| MC12468 | MEDICARE PIN (08) | VA | |
| 10040880P | OTHER (01) | VA | SENTARA HEALTHCARE |
| MC12210 | MEDICARE PIN (08) | VA |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104072297, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 53 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
COLONIAL HEIGHTS, VA 23834
COLONIAL HEIGHTS, VA 23834
COLONIAL HEIGHTS, VA 23834
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104072297, enumerated as an "individual" on August 08, 2008.
The provider is located at 436 CLAREMONT CT SUITE 100 COLONIAL HEIGHTS, VA 23834 and the phone number is (804) 526-2121.
Physician Assistant with taxonomy code 363A00000X.
The provider might be accepting Accepts: Medicare, Medicaid and Railroad Medicare. Please consult your insurance carrier or call the provider to verify.
