1. Home
  2. Directory
  3. Wisconsin
  4. Portage
  5. Emergency Medicine
  6. NPI Profile

THOMAS V JACKSON MD
NPI 1700862992
Emergency Medicine in Portage, WI

Active since December 20, 2005
2817 NEW PINERY RD, DIVINE SAVIOR HEALTHCARE INC, PORTAGE, WI 53901(608) 742-4131(608) 745-5173 Get Directions Write a Review

NPPES record last updated: January 30, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Thomas V Jackson Md NPPES

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

THOMAS V JACKSON MD (NPI 1700862992) is an individual emergency medicine provider in Portage, Wisconsin, licensed in Wisconsin (21269020) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1700862992
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameTHOMAS V JACKSONCredential: MD
Location Address2817 NEW PINERY RD, DIVINE SAVIOR HEALTHCARE INCPortage, WI 53901-9257
Mailing AddressPo Box 387, Divine Savior Healthcare IncPortage, WI 53901-0387 · (608) 742-4131 · Fax (608) 745-5173
Phone(608) 742-4131
Fax(608) 745-5173
Sole ProprietorNo
Enumeration DateDecember 20, 2005
Last NPPES UpdateJanuary 30, 2012
✔ NPI 1700862992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in WI · 21269020
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
2817 NEW PINERY RD, Portage, WI 53901
Open in Google Maps ↗

Other Identifiers 3

Medicaid30128500WI
Medicare PIN000200230WI
Medicare UPINF25304

Other Providers at the Same Location NPPES 20

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

BRITTANY LEIGH READ CCC-SLP
Speech-Language Pathologist
2817 NEW PINERY RD
PORTAGE, WI 53901
Columbia County (608) 742-4131
ELIZABETH SHARRON REDDEMAN DPT
Physical Therapist
2817 NEW PINERY RD
PORTAGE, WI 53901
Columbia County (608) 745-6290
MRS. BONNIE SUE STANISLAWSKI AU. D.
Audiologist-Hearing Aid Fitter
2817 NEW PINERY RD, SUITE 103
PORTAGE, WI 53901
Columbia County (608) 745-6290
MADISON LEE PHARMD
Pharmacist
2817 NEW PINERY RD
PORTAGE, WI 53901
Columbia County (608) 742-4131
DEBORAH BRZYCKI CRNA
Nurse Anesthetist, Certified Registered
2817 NEW PINERY RD
PORTAGE, WI 53901
Columbia County (262) 416-8317
TERRA THIMM
Emergency Medicine
2817 NEW PINERY RD
PORTAGE, WI 53901
Columbia County (608) 742-4131
DILLON VIA
Physician Assistant
2817 NEW PINERY RD
PORTAGE, WI 53901
Columbia County (608) 742-4131
MICHAEL C WALTERS MD
Emergency Medicine
2817 NEW PINERY RD
PORTAGE, WI 53901
Columbia County (608) 745-5689

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 Thomas Jackson's NPI number?

The NPI number for Thomas Jackson is 1700862992. It was assigned to this individual provider in the NPPES registry on December 20, 2005.

Where is Thomas Jackson located?

Thomas Jackson practices at 2817 New Pinery Rd Divine Savior Healthcare Inc, Portage, WI 53901. The listed phone number is (608) 742-4131.

What is Thomas Jackson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

When was this NPI record last updated?

The NPPES record for Thomas Jackson was last updated on January 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.