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DR. KEVIN GORDON JACKSON M.D.
NPI 1225032782
Family Medicine - Geriatric Medicine in Phoenix, AZ

Active since June 11, 2005PECOS Enrolled
7600 N 16TH ST STE 112, PHOENIX, AZ 85020(602) 830-0605 Get Directions Write a Review

NPPES record last updated: April 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kevin Gordon Jackson M.d. NPPES

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

DR. KEVIN GORDON JACKSON M.D. (NPI 1225032782) is an individual geriatric medicine provider in Phoenix, Arizona, licensed in Arizona (22105) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225032782
Entity TypeIndividualMale
Primary Taxonomy207QG0300X
Provider Legal NameDR. KEVIN GORDON JACKSONCredential: M.D.
Location Address7600 N 16TH ST STE 112Phoenix, AZ 85020-4446
Mailing Address7600 N 16th St Ste 112Phoenix, AZ 85020-4446 · (602) 830-0605
Phone(602) 830-0605
Sole ProprietorNo
Enumeration DateJune 11, 2005
Last NPPES UpdateApril 13, 2023
NPPES CertifiedApril 13, 2023
✔ NPI 1225032782 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
License✔ Licensed in AZ · 22105
Definition
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
7600 N 16TH ST STE 112, Phoenix, AZ 85020
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Other Identifiers 2

Medicaid428525AZ
OtherAZ0728320AZ · Blue Cross Of Arizona

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kevin Gordon Jackson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85020 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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

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

COPPER SKY HOSPICE LLC
Hospice Care, Community Based
7600 N 16TH ST STE 112
PHOENIX, AZ 85020
Maricopa County (602) 830-0605

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 Kevin Jackson's NPI number?

The NPI number for Kevin Jackson is 1225032782. It was assigned to this individual provider in the NPPES registry on June 11, 2005.

Where is Kevin Jackson located?

Kevin Jackson practices at 7600 N 16th St Ste 112, Phoenix, AZ 85020. The listed phone number is (602) 830-0605.

What is Kevin Jackson's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Is Kevin Jackson enrolled in Medicare?

Yes. Kevin Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kevin Jackson was last updated on April 13, 2023. 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.