Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1972616043 Deactivated / Inactive NPI Female Practitioner

Dr. Conchita Jackson , MD

General Practice • Miami, FL

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

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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, Dr. Conchita Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 15, 2006
NPI Deactivation Date July 29, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Conchita Jackson, MD was a registered General Practice practicing in Miami, FL. Throughout an active medical career spanning 14 years, Dr. Jackson provided care at the practice location at 10 NW 42ND AVE until profile deactivation on 2020-07-29.

Practice Location & Contact Primary Location

Practice Address

10 Nw 42nd Ave
Ste#300

Miami, FL 331265473

Telephone 3057740742
Fax 3057740836
Associated Practice Facility / Clinic
🏢 Millennium Rehab Center Inc Facility NPI 1902879679

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Miami, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 36.1 Yrs
State Avg: 26.1 Yrs
Regional Practice Density
333 Specialists

Practicing in Miami, FL (2490 Statewide)

Telehealth Adoption Rate
7.8% 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

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License FL ME91449

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

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

2 Associated Practitioners
Dr. Jose Pena , MD

General Practice

NPI 1437264686

Doctor of Medicine (M.D.)

NPI 1811002090

Doctor of Medicine (M.D.)

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 July 29, 2020

Record deactivated on July 29, 2020

NPI Profile Active July 01, 2010

NPI status registered as active in NPPES database

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Updated Practice Location July 01, 2010

Registered at 10 NW 42ND AVE, STE#300, MIAMI, FL 331265473 (Tel: 3057740742)

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Updated Business Mailing Address July 01, 2010

Registered at 10 NW 42ND AVE, STE#300, MIAMI, FL 331265473 (Tel: 3057740742)

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Provider Name / Credentials Updated July 01, 2010

Recorded as CONCHITA JACKSON, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 01, 2010

General Practice (License #ME91449 in FL)

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Initial NPI Registration & Enumeration August 15, 2006

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: 1972616043
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 15, 2006
Last Update: July 01, 2010
Deactivation Date: July 29, 2020

Mailing Address

10 Nw 42nd Ave, Ste#300

Miami, FL 331265473

Phone: 3057740742

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.