Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1619975398 Individual Practitioner Male Practitioner

Dr. Rodney Mark Jackson , MD, FAAP

Specialist • Anthem, AZ

Professional Overview & Biography Verified Profile Summary

Dr. Rodney Jackson, MD, FAAP is a registered healthcare professional specializing in Specialist in Anthem, AZ. Practice services are available at 3654 W ANTHEM WAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3654 W Anthem Way
Suite B-114

Anthem, AZ 850860455

Telephone 6235510442
Fax 6235517389
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Anthem, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 35.9 Yrs
Regional Practice Density
1 Specialists

Practicing in Anthem, AZ (826 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License AZ 28940

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
576077 (AZ)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1558088252

Nurse Practitioner

NPI 1760594543

Doctor of Medicine (M.D.)

Dana Nichols , NP-C

Nurse Practitioner - Family

NPI 1902540909

Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2007

Registered at 3654 W ANTHEM WAY, SUITE B-114, ANTHEM, AZ 850860455 (Tel: 6235510442)

📍
Updated Business Mailing Address July 09, 2007

Registered at 3654 W ANTHEM WAY, SUITE B-114, ANTHEM, AZ 850860455 (Tel: 6235510442)

👤
Provider Name / Credentials Updated July 09, 2007

Recorded as RODNEY JACKSON, MD,FAAP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Specialist (License #28940 in AZ)

🟢
Initial NPI Registration & Enumeration July 07, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619975398
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 07, 2005
Last Update: July 09, 2007
Sole Proprietor: No

Mailing Address

3654 W Anthem Way, Suite B-114

Anthem, AZ 850860455

Phone: 6235510442

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.