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Deactivated NPI 1891792552 Deactivated / Inactive NPI Male Practitioner

Robert Brian Jackson , RT (ARRT)

Radiologic Technologist - Radiography • Phoenix, AZ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Robert Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 07, 2005
NPI Deactivation Date June 10, 2021
Total Practice Duration ~16 Years of Practice (2005 – 2021)

Professional Overview & Biography Verified Profile Summary

Robert Jackson, RT (ARRT) was a registered Radiologic Technologist - Radiography practicing in Phoenix, AZ. Throughout an active medical career spanning 16 years, Robert Jackson provided care at the practice location at 2011 W MULBERRY DR until profile deactivation on 2021-06-10.

Practice Location & Contact Primary Location

Practice Address

2011 W Mulberry Dr

Phoenix, AZ 850155720

Telephone 6022419729
Fax 6022949729
Associated Practice Facility / Clinic
🏢 Arizona Portable Imaging Llc Facility NPI 1356349666

Specialty Benchmarks & Practice Insights

Comparative analytics for Radiologic Technologist - Radiography in Phoenix, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Phoenix, AZ (20 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

Radiologic Technologist - Radiography Primary Specialty

NUCC Taxonomy Code: 2471C3402X

State License AZ CRT-2225

A radiologic technologist who specializes in radiography (also known as x-rays) and is appropriately educated and trained, consistent with nationally recognized standards, state statute, and facility policy in performance of radiographs, exam techniques, equipment protocols, radiation safety, and patient care.

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated June 10, 2021

Record deactivated on June 10, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2011 W MULBERRY DR, PHOENIX, AZ 850155720 (Tel: 6022419729)

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Updated Business Mailing Address July 08, 2007

Registered at 2011 W MULBERRY DR, PHOENIX, AZ 850155720 (Tel: 6022419729)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT JACKSON, RT (ARRT)

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Radiologic Technologist (License #CRT-2225 in AZ)

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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: 1891792552
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 07, 2005
Last Update: July 08, 2007
Deactivation Date: June 10, 2021

Mailing Address

2011 W Mulberry Dr

Phoenix, AZ 850155720

Phone: 6022419729

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

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