Mary Jackson

Physician • Callao, VA

Deactivated NPI 1992152672 Deactivated in NPPES Female Practitioner

Practice location in NPPES

421 Lively Hope Rd
Callao, VA 224352511

Phone: 8042968250

Location details and other listings

Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

This NPI Is Deactivated in NPPES

NPPES lists this NPI as deactivated as of August 28, 2025; the reason is not published. The records below are historical. They do not show whether Mary Jackson currently practices or holds a license; check the state medical board for current license status.

NPI Enumeration Date May 23, 2016

NPI Deactivation Date August 28, 2025

NPI Active Period 2016 – 2025

Practice Location & Contact Primary Location

Practice Address

421 Lively Hope Rd

Callao, VA 224352511

Telephone 8042968250

Fax 8045295005

Before You Book

Paying without insurance? Prepare a cost-estimate request

Ask about interpreters and office accessibility

Organization at the Same NPPES Address or Phone

Access Medical Transportation Llc Facility NPI 1538680673

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

What Public CMS Data Show

These CMS figures cover limited populations and published records; they are not quality ratings or medical advice.

Physician: NPPES taxonomy is a reported classification, not proof of board certification.

NPI first issued

2016

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Compared with the same specialty in Callao and Virginia

Comparisons are not shown because NPPES lists this NPI as deactivated.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Non-emergency Medical Transport (VAN) Primary Specialty

NUCC Taxonomy Code: 343900000X

A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Virginia Department of Health Professions.

Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events

⚠️

NPI Profile Deactivated August 28, 2025

NPPES lists this NPI as deactivated as of August 28, 2025; the reason is not published.

✅

NPI Profile Active May 23, 2016

NPI status registered as active in NPPES database

📍

Practice Location (Initial Record) May 23, 2016

Registered at 421 LIVELY HOPE RD, CALLAO, VA 224352511 (Tel: 8042968250)

📍

Business Mailing Address (Initial Record) May 23, 2016

Registered at 421 LIVELY HOPE RD, CALLAO, VA 224352511 (Tel: 8042968250)

👤

Provider Name / Credentials (Initial Record) May 23, 2016

Recorded as MARY JACKSON

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 23, 2016

Non-emergency Medical Transport (VAN)

🟢

Initial NPI Registration & Enumeration May 23, 2016

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1992152672

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 23, 2016

Last Update: May 23, 2016

Deactivation Date: August 28, 2025

Update or Correct Profile

Mailing Address

421 Lively Hope Rd

Callao, VA 224352511

Phone: 8042968250

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.