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DR. DARRYL BRETT JACKSON M.D. NPI 1811041197


NPI Information

NPI: 1811041197
Provider Name: DR. DARRYL BRETT JACKSON, M.D.
Classification: Internal Medicine - 207R00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
5801 SPRUCE ST
PHILADELPHIA, PA
ZIP 19139
Phone: (610) 755-2594
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DR. Darryl Brett Jackson, M.D. is an internal medicine in Philadelphia, PA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. DR. Darryl Brett Jackson, M.D. NPI is 1811041197. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5801 SPRUCE ST
PHILADELPHIA, PA
ZIP 19139-833
Phone: (610) 755-2594

The NPI 1811041197 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 1/23/2007 and was last updated on 10/19/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineMD044865LPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10012855500001MEDICAIDPENNSYLVANIA
2F14055MEDICARE UPINPENNSYLVANIA
3JA703237MEDICARE ID-TYPE UNSPECIFIEDPENNSYLVANIA
400128550001MEDICAIDPENNSYLVANIA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.