DR. CODY RONALD JACKSON M.D.
NPI 1770715146
General Practice in San Diego, CA

Q: What is Cody Jackson's NPI number?

The NPI number for Cody Jackson is 1770715146. It was assigned to this individual provider in the NPPES registry on August 18, 2009.

Q: What is Cody Jackson's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Cody Jackson was last updated on July 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since August 18, 2009PECOS EnrolledAccepts Medicare Assignment

3900 5TH AVE STE 110, SAN DIEGO, CA 92103(858) 554-1212(858) 795-1195 Get Directions Write a Review

NPPES record last updated: July 5, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 5, 2022, Dec 14, 2021 (2 updates tracked since 2021).

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About Dr. Cody Ronald Jackson M.d. NPPES

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

DR. CODY RONALD JACKSON M.D. (NPI 1770715146) is an individual general practice provider in San Diego, California, licensed in California (A162265) and active in the NPI registry since August 2009. He is enrolled in Medicare PECOS and is a graduate of Uniformed Services Uhs Fe Hebert School Of Med (2009).

NPPES Registry Identity

NPI1770715146

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameDR. CODY RONALD JACKSONCredential: M.D.

Location Address3900 5TH AVE STE 110San Diego, CA 92103-3122

Mailing Address9850 Genesee Ave, Ste 320La Jolla, CA 92037-1208 · (858) 554-1212 · Fax (858) 795-1195

Phone(858) 554-1212

Fax(858) 795-1195

Sole ProprietorYes

Medical School CMSUniformed Services Uhs Fe Hebert School Of MedGraduated 2009

Enumeration DateAugust 18, 2009

Last NPPES UpdateJuly 5, 20222 updates tracked since enumeration

NPPES CertifiedJuly 5, 2022

✔ NPI 1770715146 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in CA · A162265

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedPreventive Medicine · Occupational MedicineTaxonomy 2083X0100X · License A162265 (CA)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

3900 5TH AVE STE 110, San Diego, CA 92103

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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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Cody Ronald Jackson M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345506978

PECOS Enrollment IDI20211216002632

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

117 services59 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

78 services41 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

58 services36 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

54 services40 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

27 services27 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

16 services16 patients

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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.

JORDAN LOUIE AHN

Physician Assistant