| Patrick Jackson, | |
|
1000 Blythe Blvd, Charlotte, NC 28203-5812 | |
| (704) 355-2171 | |
| Not Available |
| Full Name | Patrick Jackson |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 13 Years |
| Location | 1000 Blythe Blvd, Charlotte, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629414701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 39300 (South Carolina) | Secondary |
| 207P00000X | Emergency Medicine | 2016-00882 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Brandon Regional Hospital | Brandon, FL | Hospital |
| Memorial Hospital Of Tampa | Tampa, FL | Hospital |
| Doctors Hospital Of Sarasota | Sarasota, FL | Hospital |
| Musc Medical Center | Charleston, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Emergency Medicine Services Of Fl Llc | 8426413931 | 660 |
| Sound Physicians Emergency Medicine Of South Carolina Llc | 2163702739 | 46 |
| Musc Community Physicians | 6507260668 | 1322 |
| Entity Name | Emergency Medicine Services Of Fl Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043917180 PECOS PAC ID: 8426413931 Enrollment ID: O20230504001881 |
| Mailing Address | Practice Location Address |
|---|---|
| Patrick Jackson, 1000 Blythe Blvd, Charlotte, NC 28203-5812 Ph: () - | Patrick Jackson, 1000 Blythe Blvd, Charlotte, NC 28203-5812 Ph: (704) 355-2171 |
Chelsea Kolshak, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-3658 | |
Nicole Hadley, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 136 E 36t St Suite 200, Charlotte, NC 28206 Phone: 704-801-3400 | |
Neha Ray, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-3181 Fax: 704-355-7047 | |
Dr. Hannah Elizabeth Corral, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-3658 | |
John B Clark Jr., M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1900 Randolph Rd, Ste 900, Charlotte, NC 28207 Phone: 704-377-2424 Fax: 704-377-2687 | |
Kevin Hale Black, DDS, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-2000 | |
Nilesh K. Patel, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Blythe Blvd, Charlotte, NC 28203 Phone: 704-355-2171 |