JACKSON FAMILY MEDICINE, LLC
NPI 1780825224
Clinic/Center - Primary Care in Waldorf, MD
About Jackson Family Medicine, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKSON FAMILY MEDICINE, LLC (NPI 1780825224) is a healthcare organization registered as a primary care in Waldorf, Maryland and active in the NPI registry since March 2009. The organization lists Dainty J Jackson, Doctor, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jackson Family Medicine, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Jackson Family Medicine, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Jackson Family Medicine, LLC's NPI number?
The NPI number for Jackson Family Medicine, LLC is 1780825224. It was assigned to this organization in the NPPES registry on March 12, 2009.
Where is Jackson Family Medicine, LLC located?
Jackson Family Medicine, LLC is located at 10 Saint Patricks Dr #502, Waldorf, MD 20603. The listed phone number is (301) 885-3350.
What is Jackson Family Medicine, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Jackson Family Medicine, LLC enrolled in Medicare?
Yes. Jackson Family Medicine, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jackson Family Medicine, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Jackson Family Medicine, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Jackson Family Medicine, LLC was last updated on March 12, 2009. 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.
# Jackson Family Medicine, Llc · NPI 1780825224
Primary Care organization in Waldorf, Maryland. Organization record, active in the CMS NPPES registry since March 12, 2009.
## Identity
- **NPI:** 1780825224 (Entity type: Organization)
- **Enumerated:** March 12, 2009
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Dainty Jackson, DOCTOR
## Practice location
- **Address:** 10 SAINT PATRICKS DR, #502, Waldorf, MD 20603-4527
- **Phone:** (301) 885-3350 · **Fax:** (301) 885-0061
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 12, 2009
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Source: [NPI Profile](https://npiprofile.com/npi/1780825224) · Data from the CMS NPPES public registry.