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KENNETH JASON JACKSON MD
NPI 1174083810
Family Medicine in Lebanon, NH

Active since March 20, 2019PECOS EnrolledAccepts Medicare Assignment
69.4/100
CMS Quality Rating
18 OLD ETNA RD, LEBANON, NH 03766(603) 650-5000 Get Directions Write a Review

NPPES record last updated: August 19, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 19, 2022, Mar 20, 2019 (2 updates tracked since 2019).

About Kenneth Jason Jackson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH JASON JACKSON MD (NPI 1174083810) is an individual family medicine provider in Lebanon, New Hampshire, licensed in New Hampshire (22456) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, is affiliated with Cape Cod Hospital, and is a graduate of Howard University College Of Medicine (2019).

NPPES Registry Identity

NPI1174083810
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameKENNETH JASON JACKSONCredential: MD
Location Address18 OLD ETNA RDLebanon, NH 03766-1937
Mailing Address18 Old Etna RdLebanon, NH 03766-1937
Phone(603) 650-5000
Sole ProprietorNo
Medical School CMSHoward University College Of MedicineGraduated 2019
Enumeration DateMarch 20, 2019
Last NPPES UpdateAugust 19, 20222 updates tracked since enumeration
NPPES CertifiedAugust 17, 2022
✔ NPI 1174083810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NH · 22456
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
18 OLD ETNA RD, Lebanon, NH 03766
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kenneth Jason Jackson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052787389
PECOS Enrollment IDI20240717000516
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
278 services206 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
64 services64 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
53 services49 patients
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211
This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
20 services17 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
19 services15 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
17 services17 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cape Cod Hospital

Acute Care Hospitals · Hyannis, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220012
Location27 Park StreetHyannis, MA 02601 · Barnstable County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 03766 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.14 typical visit price
range $57.75 – $174.26
Typical copayment $22.28 (range $14.43 – $43.56)
Most-billed visit code 99203
Established Patient
$101.54 typical visit price
range $18.70 – $142.15
Typical copayment $25.38 (range $4.67 – $35.53)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

69.4/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality55.64
Promoting Interoperability100
Improvement Activities40
Cost42.36

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ZANIRA FAZAL M.D.
Internal Medicine
18 OLD ETNA RD
LEBANON, NH 03766
Grafton County (603) 650-4000
DR. BRIAN SIMMONS MD
Dermatology
18 OLD ETNA RD
LEBANON, NH 03766
Grafton County (603) 650-3100
JEFFREY K SHORNICK MD
Dermatology
18 OLD ETNA RD, DHMC - DERMATOLOGY
LEBANON, NH 03766
Grafton County (603) 650-3100
NATHANIEL T SHERMAN PA-C
Physician Assistant
18 OLD ETNA RD
LEBANON, NH 03766
Grafton County (603) 650-4000
JAMIE PLIMPTON PA-C
Physician Assistant
18 OLD ETNA RD
LEBANON, NH 03766
Grafton County (603) 650-4000
CHRISTOPHER J VODILA ARNP
Nurse Practitioner (Family)
18 OLD ETNA RD
LEBANON, NH 03766
Grafton County (603) 650-5000
ZOE FROLKING
Pediatrics
18 OLD ETNA RD
LEBANON, NH 03766
Grafton County (603) 650-5000
DR. ELAINE LOUISE FLEMING M.D.
Internal Medicine
18 OLD ETNA RD, DHMC - INTERNAL MEDICINE
LEBANON, NH 03766
Grafton County (603) 650-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Jackson's NPI number?

The NPI number for Kenneth Jackson is 1174083810. It was assigned to this individual provider in the NPPES registry on March 20, 2019.

Where is Kenneth Jackson located?

Kenneth Jackson practices at 18 Old Etna Rd, Lebanon, NH 03766. The listed phone number is (603) 650-5000.

What is Kenneth Jackson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kenneth Jackson enrolled in Medicare?

Yes. Kenneth Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Kenneth Jackson affiliated with any hospitals?

According to CMS data, Kenneth Jackson is affiliated with Cape Cod Hospital.

When was this NPI record last updated?

The NPPES record for Kenneth Jackson was last updated on August 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.