Calvin Jackson (NPI# 1740398338, PAC ID# 5799809588) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1740398338 |
| PAC ID by PECOS | 5799809588 |
| Professional Enrollment ID | I20110126000552 |
| Full Name | Calvin Jackson |
| Organization Legal Name | CSRA MEDICAL ASSOCIATES |
| Address |
2123 Wrightsboro Rd Augusta GA 30904-2304 |
| Phone Number | 7067365244 |
| Gender | M |
| Medical School | MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE |
| Graduation Year | 1987 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 8729102512 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110028 | UNIVERSITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2123 Wrightsboro Rd, Augusta, GA 30904-2304 | 7067365244 | CSRA MEDICAL ASSOCIATES |
| 350 Austin Graybill Rd, North Augusta, SC 29860-9251 | 7067365244 | CSRA MEDICAL ASSOCIATES |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | CSRA MEDICAL ASSOCIATES |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Willie M Deas | Internal Medicine | Csra Medical Associates | 350 Austin Graybill Rd, North Augusta, SC 29860-9251 |
| Street Address |
2123 WRIGHTSBORO RD |
| City | AUGUSTA |
| State | GA |
| Zip | 30904-2304 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Doris Elizabeth Tummillo | Cardiovascular Disease (cardiology) | 2050 Walton Way, Augusta, GA 30904-2305 | |
| Zulfiqar Ahmed | Internal Medicine | 2316 Wrightsboro Rd, Augusta, GA 30904-2316 | |
| Robert E Milhous | Chiropractic | 2321 Washington Rd, Augusta, GA 30904-3105 | |
| Joseph Waldo Griffin Jr. | Gastroenterology | Harrisburg Family Health Care, Inc. | 423 Crawford Ave, Augusta, GA 30904-3641 |
| Terrence James Cook | Allergy/immunology | Harrisburg Family Health Care, Inc. | 423 Crawford Ave, Augusta, GA 30904-3641 |
| Carol Collica | Physical Therapy | Neuro-developmental Treatment Programs, Inc. | 817 Crawford Ave, Augusta, GA 30904-3772 |
| Anne Griffith | Physical Therapy | Neuro-developmental Treatment Programs, Inc. | 817 Crawford Ave, Augusta, GA 30904-3772 |
| Monica K Ridlehoover | Occupational Therapy | Neuro-developmental Treatment Programs, Inc. | 817 Crawford Ave, Augusta, GA 30904-3772 |
| Judith C Bierman | Physical Therapy | Neuro-developmental Treatment Programs, Inc. | 817 Crawford Ave, Augusta, GA 30904-3772 |
| Gina M White | Occupational Therapy | Neuro-developmental Treatment Programs, Inc. | 817 Crawford Ave, Augusta, GA 30904-3772 |
| Find all physicians in zip 30904 | |||
| City | AUGUSTA |
| Zip Code | 30904 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | AUGUSTA + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Calvin Jackson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.