DR. AMANDA KAY JACKSON M.D NPI 1770875841

NPI Information

  • NPI: 1770875841
  • Provider Name: DR. AMANDA KAY JACKSON, M.D
  • Classification: Emergency Medicine - 207P00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 400 N STATE OF FRANKLIN RD
    PEDIATRIC EMERGENCY DEPARTMENT
    JOHNSON CITY, TN
    ZIP 37604
  • Phone: (423) 431-5339

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NPI Details

DR. Amanda Kay Jackson, M.D is an emergency medicine in Johnson City, TN. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Amanda Kay Jackson, M.D NPI is 1770875841. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

400 N STATE OF FRANKLIN RD
PEDIATRIC EMERGENCY DEPARTMENT
JOHNSON CITY, TN
ZIP 37604-035
Phone: (423) 431-5339

The NPI 1770875841 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/9/2011 and was last updated on 6/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsMD0000051518TENNESSEENo
2208000000XPediatrics01075191INDIANANo
3207P00000XEmergency Medicine51518TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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