Individual provider

Amanda Jackson, M.D

Pediatrics Physician Emergency Medicine Physician Medicare enrolled

Amanda Jackson, M.D is an Emergency Medicine Physician in Johnson City, TN, registered under NPI 1770875841. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 400 N STATE OF FRANKLIN RD PEDIATRIC EMERGENCY DEPARTMENT, Johnson City, TN 37604. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

400 N STATE OF FRANKLIN RD PEDIATRIC EMERGENCY DEPARTMENT, Johnson City, TN 37604 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
MD0000051518 TN Pediatrics Physician
01075191 IN Pediatrics Physician
51518 TN Emergency Medicine Physician primary

Licences are recorded in 2 states: TN, IN. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Pediatric Medicine
PAC ID
2365662913

Enrolled in Medicare 2 times, across 2 states:

StateEnrollment IDProvider type
Tennessee I20141001002673 Practitioner - Pediatric Medicine
Indiana I20230309000616 Practitioner - Pediatric Medicine

Medicare enrolment is recorded as approved under the provider type Practitioner - Pediatric Medicine. There are 2 separate enrolment records across 2 states (TN, IN). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Indiana and Tennessee. The practice address on file is in Johnson City, TN, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

IN Indiana
Licence
01075191
Specialty
Pediatrics Physician
Verify with the IN board →
TN Tennessee practice address
Licence
MD0000051518
Specialty
Pediatrics Physician
Verify with the TN board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Emergency Medicine covers

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. NUCC Health Care Provider Taxonomy, code 207P00000X
Allopathic & Osteopathic Physicians Emergency Medicine

All registered taxonomy codes

This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
208000000X Pediatrics Physician MD0000051518 TN
208000000X Pediatrics Physician 01075191 IN
207P00000X Emergency Medicine Physician 51518 TN primary

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1770875841 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateMay 9, 2011
Last updatedJul 30, 2026
StatusActive
Sole proprietorNo
GenderFemale
CredentialM.D
Practice address 400 N STATE OF FRANKLIN RD
PEDIATRIC EMERGENCY DEPARTMENT
Johnson City, TN 37604
(423) 431-5339
Mailing address 200 CORPORATE BLVD
Lafayette, LA 70508
This record was updated on Jul 30, 2026, which is recent enough that the contact details are likely still accurate.

Number check

1770875841 passes the NPI check digit test The final digit 1 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 7 7 0 8 7 5 8 4
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 7 5 0 7 7 1 8 8

Sum = 69 · next multiple of 10 = 70 · check digit = 1 · actual last digit = 1

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1770875841?
NPI 1770875841 is the National Provider Identifier assigned to Amanda Jackson, M.D in Johnson City, TN. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Emergency Medicine Physician cover?
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care…
How do I contact Amanda Jackson, M.D?
The phone number on file with NPPES is (423) 431-5339, last updated Jul 30, 2026. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Amanda Jackson, M.D accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1770875841 a valid number?
Yes. 1770875841 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.