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MR. PHILLIP ANTHONY JACKSON JR. CRNP
NPI 1992435036
Nurse Practitioner in Baltimore, MD

Active since June 13, 2022PECOS EnrolledAccepts Medicare Assignment
22 S GREENE ST, BALTIMORE, MD 21201(410) 328-8667 Get Directions Write a Review

NPPES record last updated: June 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Phillip Anthony Jackson Jr. Crnp NPPES

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

MR. PHILLIP ANTHONY JACKSON JR. CRNP (NPI 1992435036) is an individual nurse practitioner in Baltimore, Maryland, licensed in Maryland (R230527) and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1992435036
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameMR. PHILLIP ANTHONY JACKSON JR.Credential: CRNP
Location Address22 S GREENE STBaltimore, MD 21201-1544
Mailing Address22 S Greene StBaltimore, MD 21201-1544 · (410) 328-8667
Phone(410) 328-8667
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJune 13, 2022
NPPES CertifiedJune 10, 2022
✔ NPI 1992435036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MD · R230527
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
22 S GREENE ST, Baltimore, MD 21201
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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

Mr. Phillip Anthony Jackson Jr. Crnp 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 ID5395121560
PECOS Enrollment IDI20220927000051
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 4

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.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
25 services25 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.
15 services13 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
13 services13 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.08 typical visit price
range $60.73 – $183.44
Typical copayment $23.52 (range $15.18 – $45.86)
Most-billed visit code 99203
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. LEONARD ANANG SOWAH M.D.
Internal Medicine
22 S GREENE ST
BALTIMORE, MD 21201
Baltimore City (410) 706-4619
VISHAL BHATNAGAR MD
Student in an Organized Health Care Education/Training Program
22 S GREENE ST, MEDICINE, N3E09
BALTIMORE, MD 21201
Baltimore City (410) 328-6110
NANCE J FOX P.A.-C
Physician Assistant (Medical)
22 S GREENE ST, G2K36
BALTIMORE, MD 21201
Baltimore City (410) 328-1170
HILARY TAMARA WOLF MD
Pediatrics (Adolescent Medicine)
22 S GREENE ST
BALTIMORE, MD 21201
Baltimore City (410) 328-7373
MS. LINDSAY BREAM O'MEARA CRNP
Nurse Practitioner (Acute Care)
22 S GREENE ST, SUITE S4D07
BALTIMORE, MD 21201
Baltimore City (410) 328-3365
NORA T OLIVER M.D., M.P.H.
Student in an Organized Health Care Education/Training Program
22 S GREENE ST, N3E09
BALTIMORE, MD 21201
Baltimore City (410) 328-5756
SHOSHANA JO WEINER
Internal Medicine
22 S GREENE ST
BALTIMORE, MD 21201
Baltimore City (617) 214-1332
JENNA VANLIERE CANZONIERO M.D.
Internal Medicine
22 S GREENE ST, N3E09
BALTIMORE, MD 21201
Baltimore City (410) 328-5756

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 Phillip Jackson's NPI number?

The NPI number for Phillip Jackson is 1992435036. It was assigned to this individual provider in the NPPES registry on June 13, 2022.

Where is Phillip Jackson located?

Phillip Jackson practices at 22 S Greene St, Baltimore, MD 21201. The listed phone number is (410) 328-8667.

What is Phillip Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Phillip Jackson enrolled in Medicare?

Yes. Phillip Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Phillip Jackson was last updated on June 13, 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.