LEROY THOMAS JACKSON M.D. - NPI 1477633980 - Internal Medicine in Chesapeake, VA

Q: What is Leroy Jackson's NPI number?

The NPI number for Leroy Jackson is 1477633980. It was assigned to this individual provider in the NPPES registry on October 17, 2006.

Q: What is Leroy Jackson's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Q: When was this NPI record last updated?

The NPPES record for Leroy Jackson was last updated on February 15, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Leroy Thomas Jackson M.d. NPPES

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

LEROY THOMAS JACKSON M.D. (NPI 1477633980) is an individual endocrinology, diabetes & metabolism provider in Chesapeake, Virginia, licensed in Michigan (4301406300) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1477633980

Entity TypeIndividualMale

Primary Taxonomy207RE0101X

Provider Legal NameLEROY THOMAS JACKSONCredential: M.D.

Location Address3205 CHURCHLAND BLVDChesapeake, VA 23321-5205

Mailing Address3205 Churchland BlvdChesapeake, VA 23321-5205 · (757) 484-7822 · Fax (757) 484-7362

Phone(757) 484-7822

Fax(757) 484-7362

Sole ProprietorNo

Enumeration DateOctober 17, 2006

Last NPPES UpdateFebruary 15, 2013

✔ NPI 1477633980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians

Taxonomy Code207RE0101X

License✔ Licensed in MI · 4301406300

Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

3205 CHURCHLAND BLVD, Chesapeake, VA 23321

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Other Identifiers 3

Other1477633980AL · Npi

Medicare PIN102I466136AL

OtherBLUE CROSSAL · 51109153

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

100%126 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 10

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

MS. SUZANNE LYNNE NICKEL FNP-C

Nurse Practitioner (Family)