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MARK A JACKSON MD PLC
NPI 1740439025
Family Medicine - Geriatric Medicine in Traverse City, MI

Active since September 11, 2008
1000 PAVILLIONS CIR, TRAVERSE CITY, MI 49684(231) 935-0913(231) 935-0984 Get Directions Write a Review

NPPES record last updated: December 18, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mark A Jackson Md Plc NPPES

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

MARK A JACKSON MD PLC (NPI 1740439025) is a healthcare organization registered as a geriatric medicine in Traverse City, Michigan and active in the NPI registry since September 2008. The organization lists Mark A Jackson, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1740439025
Entity TypeOrganization
Primary Taxonomy207QG0300X
Legal Business NameMARK A JACKSON MD PLC
Location Address1000 PAVILLIONS CIRTraverse City, MI 49684-3198
Mailing AddressPo Box 1267Traverse City, MI 49685-1267 · (231) 935-0913 · Fax (231) 935-0984
Phone(231) 935-0913
Fax(231) 935-0984
Organization SubpartNo
Authorized OfficialMark A JacksonPhysician/owner · (231) 935-0913
Enumeration DateSeptember 11, 2008
Last NPPES UpdateDecember 18, 2008
✔ NPI 1740439025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
License✔ Licensed in MI · 4301051555
Definition
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
1000 PAVILLIONS CIR, Traverse City, MI 49684
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Other Identifiers 11

Other080B813500MI · Bcbs Id#
Other0B81350MI · Bcbs Group Id#
OtherMI1114001MI · Medicare Ind Ptan
Medicaid1073585238MI
Other0802802421MI · Bcbs Pin#
Other1740439025MI · Group Npi
Medicare UPINB43877MI
Medicare PIN0MI1114001MI
Other0MI1114MI · Medicare Group
Medicare PINMI1114MI
Other1073585238MI · Ind Npi

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 17

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

HARRIET SUE BARNER NP
Nurse Practitioner
1000 PAVILLIONS CIR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 932-3000
HANNAH SCHWEIKART
Occupational Therapist
1000 PAVILLIONS CIR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 932-3000
KATHY DIANE REID APRN,BC
Nurse Practitioner (Gerontology)
1000 PAVILLIONS CIR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 932-3801
MRS. NICOLE LYNN DEWEY OT
Occupational Therapist
1000 PAVILLIONS CIR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 932-3000
JENNIFER BALOGH
Occupational Therapist
1000 PAVILLIONS CIR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 932-3000
JACQUELINE MICHELE AICHER M.S., CCC-SLP
Speech-Language Pathologist
1000 PAVILLIONS CIR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 932-3000
DAWN LOUISE BROWN AGANP
Nurse Practitioner (Gerontology)
1000 PAVILLIONS CIR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 932-3000
MICHAEL NEWBERRY OTR/L
Occupational Therapist
1000 PAVILLIONS CIR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 932-3000

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 Mark A Jackson MD Plc's NPI number?

The NPI number for Mark A Jackson MD Plc is 1740439025. It was assigned to this organization in the NPPES registry on September 11, 2008.

Where is Mark A Jackson MD Plc located?

Mark A Jackson MD Plc is located at 1000 Pavillions Cir, Traverse City, MI 49684. The listed phone number is (231) 935-0913.

What is Mark A Jackson MD Plc's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

When was this NPI record last updated?

The NPPES record for Mark A Jackson MD Plc was last updated on December 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.