1. Home
  2. Directory
  3. Indiana
  4. Richmond
  5. Nurse Practitioner
  6. NPI Profile

DOUGLAS JACKSON NP
NPI 1184277857
Nurse Practitioner - Acute Care in Richmond, IN

Active since July 22, 2019PECOS EnrolledAccepts Medicare Assignment
1100 REID PKWY, RICHMOND, IN 47374(765) 983-3000(765) 935-8944 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Sep 23, 2021, Nov 5, 2020, Jul 22, 2019 (3 updates tracked since 2019).

About Douglas Jackson Np NPPES

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

DOUGLAS JACKSON NP (NPI 1184277857) is an individual acute care provider in Richmond, Indiana, licensed in Ohio (APRN.CNP.0027550) and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS, is affiliated with Miami Valley Hospital, and maintains a secondary practice location in Kettering.

NPPES Registry Identity

NPI1184277857
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameDOUGLAS JACKSONCredential: NP
Location Address1100 REID PKWYRichmond, IN 47374-1157
Mailing Address1100 Reid Parkway, Medical Staff ServiceRichmond, IN 47374 · (765) 935-5331 · Fax (765) 983-3219
Phone(765) 983-3000
Fax(765) 935-8944
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJuly 22, 2019
Last NPPES UpdateOctober 30, 20243 updates tracked since enumeration
NPPES CertifiedOctober 30, 2024
✔ NPI 1184277857 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in OH · APRN.CNP.0027550
Also ListedNurse PractitionerTaxonomy 363L00000X · License 71009145A (IN)
1100 REID PKWY, Richmond, IN 47374
Open in Google Maps ↗

Secondary Practice Location 1

Location 13533 Southern Blvd Ste 5650Kettering, OH 45429-1263 · Phone (937) 294-3611 · Fax (937) 294-9010

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Douglas Jackson Np 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 ID9032445853
PECOS Enrollment IDI20210202001241
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.

Medicare Billing Reassignments

8

Medicare enrollment records show Douglas Jackson reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mvhe Inc
32 mi
Family Medicine
3038 OLIVE RD
Trotwood, OH 45426
  • Reassigned Medicare billing, Ohio enrollment
  • 744 clinicians in this Medicare group
NPI 1841243862 (937) 208-7050
Premier Health Specialists Inc
33 mi
Orthopaedic Surgery
9000 N MAIN ST, STE 227
Dayton, OH 45415
  • Reassigned Medicare billing, Ohio enrollment
  • 812 clinicians in this Medicare group
NPI 1538398078 (937) 832-4773
Upper Valley Professional Corporation
37 mi
Family Medicine
3130 N COUNTY ROAD 25A
Troy, OH 45373
  • Reassigned Medicare billing, Ohio enrollment
  • 405 clinicians in this Medicare group
NPI 1407872518 (937) 440-7497
Sinclair Physician Services, LLC
38 mi
Hospitalist
1 WYOMING ST
Dayton, OH 45409
  • Reassigned Medicare billing, Ohio enrollment
  • 270 clinicians in this Medicare group
NPI 1063289601 (937) 208-8000
Kettering Independent Medical Group Inc
38 mi
Orthopaedic Surgery
1 PRESTIGE PL, SUITE 910
Miamisburg, OH 45342
  • Reassigned Medicare billing, Ohio enrollment
  • 984 clinicians in this Medicare group
NPI 1629387865 (937) 762-1629
Hisey Physician Services, LLC
40 mi
Hospitalist
1 MEDICAL CENTER DR
Middletown, OH 45005
  • Reassigned Medicare billing, Ohio enrollment
  • 263 clinicians in this Medicare group
NPI 1073380614 (513) 974-2111
Usacs Critical Care Medicine Services Of Ohio, LLC
57 mi
Critical Care Medicine
100 MEDICAL CENTER DR
Springfield, OH 45504
  • Reassigned Medicare billing, Ohio enrollment
  • 49 clinicians in this Medicare group
NPI 1104560580 (844) 474-4019
Usacs Integrated Acute Care Services Of Ohio, LLC
57 mi
Internal Medicine
100 MEDICAL CENTER DR
Springfield, OH 45504
  • Reassigned Medicare billing, Ohio enrollment
  • 494 clinicians in this Medicare group
NPI 1043805690 (844) 474-4019

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
62 services61 patients

Hospital Affiliations CMS Care Compare 4

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

Miami Valley Hospital

Acute Care Hospitals · Dayton, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360051
LocationOne Wyoming StreetDayton, OH 45409 · Montgomery County
Emergency services Birthing friendly

Atrium Medical Center

Acute Care Hospitals · Franklin, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360076
LocationOne Medical Center DriveFranklin, OH 45005 · Warren County
Emergency services Birthing friendly

Springfield Regional Medical Center

Acute Care Hospitals · Springfield, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360086
Location100 Medical Center DriveSpringfield, OH 45504 · Clark County
Emergency services Birthing friendly

Upper Valley Medical Center

Acute Care Hospitals · Troy, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360174
Location3130 North County Road 25ATroy, OH 45373 · Miami County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47374 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

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.

JUSTIN VARGHESE
Internal Medicine
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000
MALLORY J CROSS PA-C
Physician Assistant
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000
DR. JOHN E MCGINTY IV M.D.
Internal Medicine (Cardiovascular Disease)
1100 REID PKWY, SUITE 210
RICHMOND, IN 47374
Wayne County (765) 962-1337
THOMAS P. GLYNN JR. M.D.
Radiology (Diagnostic Radiology)
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000
SADIA KHAN MD
Student in an Organized Health Care Education/Training Program
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3822
DR. TYLER BROOKS FREDENBURG MD
Radiology (Diagnostic Radiology)
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3164
AHMAD S KHATRI MD
Family Medicine
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3492
SHARON SMITH LAT, ATC
Specialist/Technologist (Athletic Trainer)
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000

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 Douglas Jackson's NPI number?

The NPI number for Douglas Jackson is 1184277857. It was assigned to this individual provider in the NPPES registry on July 22, 2019.

Where is Douglas Jackson located?

Douglas Jackson practices at 1100 Reid Pkwy, Richmond, IN 47374. The listed phone number is (765) 983-3000.

What is Douglas Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Douglas Jackson enrolled in Medicare?

Yes. Douglas 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.

Which organizations bill Medicare for Douglas Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Douglas Jackson reassigns Medicare benefits to 8 organizations: Mvhe Inc (Trotwood, OH), Premier Health Specialists Inc (Dayton, OH), Upper Valley Professional Corporation (Troy, OH), Sinclair Physician Services, LLC (Dayton, OH), Kettering Independent Medical Group Inc (Miamisburg, OH) and 3 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Douglas Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Douglas Jackson accept?

Health plans from Anthem Blue Cross and Blue Shield and UnitedHealthcare list Douglas Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Douglas Jackson affiliated with any hospitals?

According to CMS data, Douglas Jackson is affiliated with Miami Valley Hospital, Atrium Medical Center, Springfield Regional Medical Center and Upper Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Douglas Jackson was last updated on October 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.