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DR. RODNEY MARK JACKSON MD,FAAP
NPI 1619975398
Specialist in Anthem, AZ

Active since July 07, 2005
3654 W ANTHEM WAY, SUITE B-114, ANTHEM, AZ 85086(623) 551-0442(623) 551-7389 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Rodney Mark Jackson Md,faap NPPES

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

DR. RODNEY MARK JACKSON MD,FAAP (NPI 1619975398) is an individual specialist in Anthem, Arizona, licensed in Arizona (28940) and active in the NPI registry since July 2005.

NPPES Registry Identity

NPI1619975398
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. RODNEY MARK JACKSONCredential: MD,FAAP
Location Address3654 W ANTHEM WAY, SUITE B-114Anthem, AZ 85086-0455
Mailing Address3654 W Anthem Way, Suite B-114Anthem, AZ 85086-0455 · (623) 551-0442 · Fax (623) 551-7389
Phone(623) 551-0442
Fax(623) 551-7389
Sole ProprietorNo
Enumeration DateJuly 7, 2005
Last NPPES UpdateJuly 9, 2007
✔ NPI 1619975398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in AZ · 28940
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
3654 W ANTHEM WAY, Anthem, AZ 85086
Open in Google Maps ↗

Other Identifiers 1

Medicaid576077AZ

Other Providers at the Same Location NPPES 4

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

CHARLYNN DARRAH MSPT
Physical Therapist
3654 W ANTHEM WAY, SUITE B102
ANTHEM, AZ 85086
Maricopa County (623) 551-9706
DR. DAVID SUNG-YEN YIP M.D.
Pediatrics
3654 W ANTHEM WAY, SUITE B-114
ANTHEM, AZ 85086
Maricopa County (623) 551-0442
NICOLE BESANA PT
Physical Therapist
3654 W ANTHEM WAY, SUITE B102
ANTHEM, AZ 85086
Maricopa County (623) 551-9706
DAISY MOUNTAIN SURGICAL ASSOCIATES PLLC
Surgery
3654 W ANTHEM WAY, SUITE B102
ANTHEM, AZ 85086
Maricopa County (623) 551-3280

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 Rodney Jackson's NPI number?

The NPI number for Rodney Jackson is 1619975398. It was assigned to this individual provider in the NPPES registry on July 7, 2005.

Where is Rodney Jackson located?

Rodney Jackson practices at 3654 W Anthem Way Suite B-114, Anthem, AZ 85086. The listed phone number is (623) 551-0442.

What is Rodney Jackson's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Rodney Jackson was last updated on July 9, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.