Gloria M Jackson, MD is a medicare enrolled "Family Medicine" physician in Grafton, Virginia. She went to University Of Florida College Of Medicine and graduated in 1986 and has 38 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Tidewater Physicians Multispecialty Group Pc and her current practice location is
222 Grafton Dr, Grafton, Virginia. You can reach out to her office (for appointments etc.) via phone at
(757) 898-7737.
Gloria M Jackson is licensed to practice in Virginia (license number 0101043609) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1235123423.
Physician's Profile
| Full Name | Gloria M Jackson |
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| Gender | Female |
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| Speciality | Family Practice |
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| Experience | 38 Years |
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| Location | 222 Grafton Dr, Grafton, Virginia |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Gloria M Jackson attended and graduated from University Of Florida College Of Medicine in 1986
NPI Data:
- NPI Number: 1235123423
- Provider Enumeration Date: 09/02/2005
- Last Update Date: 02/07/2020
Medicare PECOS Information:
- PECOS PAC ID: 5698715639
- Enrollment ID: I20050509000878
Medical Identifiers
Medical identifiers for Gloria M Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1235123423 | NPI | - | NPPES |
| 010158745 | Medicaid | VA | |
| P00291647 | Other | | RR/MEDICARE |
| 177855 | Other | VA | ANTHEM |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 0101043609 (Virginia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Tidewater Physicians Multispecialty Group Pc | 2860398526 | 246 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gloria M Jackson allows following entities to bill medicare on her behalf.
| Entity Name | Tidewater Physicians Multispecialty Group Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1902848294
PECOS PAC ID: 2860398526
Enrollment ID: O20031211000980 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gloria M Jackson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Gloria M Jackson, MD
860 Omni Blvd Ste 101,
Newport News, VA 23606-4430
Ph: (757) 232-8769 | Gloria M Jackson, MD
222 Grafton Dr,
Grafton, VA 23692-2152
Ph: (757) 898-7737 |
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