Dr. Robert Wayne Jackson

Rheumatology Jefferson County Health Center NPI1730293705

Summary

About

Dr. Robert Wayne Jackson specialises in Rheumatology. He currently works at Jefferson County Health Center in Missouri and has affiliate with 4 other institutions.

Other specialities of Dr. Robert includes Internal Medicine.

Provider Details

NPI Number 1730293705
Provider Name Robert Wayne Jackson
Credential DO
Specialization Rheumatology
Medical School Name At Still University Of Health Sciences, College Of Osteo Med, Kirksville
Graduation Year 1981
Gender M
Entity Type Individual
PAC ID by PECOS 3476448952
Professional Enrollment ID I20070312000392
Enumeration Date 08/18/2006
Last Update Date 07/08/2007

Contact Details

Business Practice address SIGLER AVE, Memphis,
63555 Missouri View on Google Map
Business Practice phone 660-465-2828
Business Practice fax 660-465-2820
Mailing address SIGLER AVE, Memphis,
63555 Missouri View on Google Map
Other phone 660-465-2828
Other fax 660-465-2820
Email Address shannonfig@domain.com Reval Email Address
Incorrect information? Update the NPI Details for Robert Wayne Jackson DO Update NPI

Payments

Total Payment Worth

$109,047.43
from 894 payments in the last 6 years

Total Cash or Cash Equivalent

$91,659.21
from 75 payments in the last 6 years

Total In-kind Items & Services

$17,388.22
from 819 payments in the last 6 years

Hospital Affilitation

Jefferson County Health Center in Memphis

Memphis, Missouri

Macon County Samaritan Memorial Hospital

Scotland County Hospital

Van Buren County Hospital

Pike County Memorial Hospital

Education & Training

At Still University Of Health Sciences, College Of Osteo Med, Kirksville

Rheumatology, 1981

Group Affiliation

Organization Name PECOS PAC ID Members
Pike County Memorial Hospital 8123015518 24
Sullivan County Memorial Hospital 7810973252 10
Van Buren County Hospital 7214829530 20
Scotland County Memorial Hospital 8224940366 20
Hannibal Clinic Operations, Llc 9931094182 63
Jefferson County Hospital 9335059575 38
Kirksville Specialty Clinic Llc 3476983370 2

Public Reporting for Performance Scores

More Details

Final MIPS Score

96.50 out of 100

Score Breakdown

Quality Category Score 96.03
PI Category Score 80.22

 

IA Category Score 40
Cost Category Score 0
Total Patients: 44
Source of Scores: apm, group
Newsletter for Healthcare Professionals

Provider Taxonomy Details

Primary Taxonomy
Taxonomy
License No.
R6C73 (Missouri)

Reference NPI Information (as per NPPES NPI Record)

Field Name Field Value
NPI 1730293705
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor N
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) Jackson
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name Robert
The first name of the provider, if the provider is an individual.
Provider Credential Text D.O.
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address SIGLER AVE
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name Memphis
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name Missouri
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 63555
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider Business Mailing Address Telephone Number 660-465-2828
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
Provider Business Mailing Address Fax Number 660-465-2820
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider First Line Business Practice Location Address SIGLER AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name Memphis
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name Missouri
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 63555
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 660-465-2828
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 660-465-2820
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date 08/18/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 07/08/2007
The date that a record was last updated or changed.
Provider Gender Code M
The code designating the provider's gender if the provider is a person.
Provider Gender Male
The provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code #1 207RR0500X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases.
Healthcare Provider Taxonomy #1
Provider License Number 1 R6C73
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1 MO
Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch 1 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.