MARY MICHAEL JACKSON DO
NPI 1881535417
Student in an Organized Health Care Education/Training Program in Memphis, TN

Active since April 06, 2026PECOS Enrolled
920 MADISON AVE STE 447, MEMPHIS, TN 38103(901) 448-1010 Get Directions Write a Review

NPPES record last updated: April 6, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Mary Michael Jackson Do NPPES

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

MARY MICHAEL JACKSON DO (NPI 1881535417) is an individual student in an organized health care education/training program in Memphis, Tennessee and active in the NPI registry since April 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1881535417
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMARY MICHAEL JACKSONCredential: DO
Location Address920 MADISON AVE STE 447Memphis, TN 38103-3438
Mailing Address920 Madison Ave Fl 2Memphis, TN 38103-3438 · (901) 448-1010
Sole ProprietorYes
Enumeration DateApril 6, 2026
NPPES CertifiedApril 6, 2026
✔ NPI 1881535417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
920 MADISON AVE STE 447, Memphis, TN 38103

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 (PECOS)

Mary Michael Jackson Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

Student in an Organized Health Care Education/Training Program
920 MADISON AVE STE 447
MEMPHIS, TN 38103
Plastic Surgery
920 MADISON AVE STE 447
MEMPHIS, TN 38103
Student in an Organized Health Care Education/Training Program
920 MADISON AVE STE 447
MEMPHIS, TN 38103
Student in an Organized Health Care Education/Training Program
920 MADISON AVE STE 447
MEMPHIS, TN 38103
Internal Medicine (Nephrology)
920 MADISON AVE STE 447
MEMPHIS, TN 38103
Student in an Organized Health Care Education/Training Program
920 MADISON AVE STE 447
MEMPHIS, TN 38103
Student in an Organized Health Care Education/Training Program
920 MADISON AVE STE 447
MEMPHIS, TN 38103
Student in an Organized Health Care Education/Training Program
920 MADISON AVE STE 447
MEMPHIS, TN 38103

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 Mary Michael Jackson's NPI number?

The NPI number for Mary Michael Jackson is 1881535417. It was assigned to this individual provider in the NPPES registry on April 6, 2026.

Where is Mary Michael Jackson located?

Mary Michael Jackson practices at 920 Madison Ave Ste 447, Memphis, TN 38103. The listed phone number is (901) 448-1010.

What is Mary Michael Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mary Michael Jackson enrolled in Medicare?

Yes. Mary Michael Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mary Michael Jackson was last updated on April 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.