KENNETH DOLEN JACKSON MD
NPI 1295898179
Surgery in Kansas City, MO

Q: What is the provider's specialty?

The provider's specialty is Surgery with taxonomy code 208600000X.

Active since December 19, 2006PECOS Enrolled

930 CARONDELET DR, SUITE 104, KANSAS CITY, MO 64114(816) 941-2222(816) 941-2282 Get Directions Write a Review

NPPES record last updated: October 15, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Kenneth Dolen Jackson Md NPPES

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

KENNETH DOLEN JACKSON MD (NPI 1295898179) is an individual surgery provider in Kansas City, Missouri, licensed in Missouri (2008033152) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295898179

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameKENNETH DOLEN JACKSONCredential: MD

Location Address930 CARONDELET DR, SUITE 104Kansas City, MO 64114-4855

Mailing Address930 Carondelet Dr 201Kansas City, MO 64114-4698 · (816) 941-2222 · Fax (816) 941-2282

Phone(816) 941-2222

Fax(816) 941-2282

Sole ProprietorNo

Enumeration DateDecember 19, 2006

Last NPPES UpdateOctober 15, 2015

✔ NPI 1295898179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in MO · 2008033152

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedOtolaryngologyTaxonomy 207Y00000X · License 9406666 (KS)

930 CARONDELET DR, Kansas City, MO 64114

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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 (PECOS)

Kenneth Dolen Jackson Md 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 64114 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

$85.82 typical visit price

range $55.29 – $168.52

Typical copayment $21.45 (range $13.82 – $42.13)

Most-billed visit code 99203

Established Patient

$69.10 typical visit price

range $17.60 – $137.20

Typical copayment $17.27 (range $4.40 – $34.30)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.