1. Home
  2. Directory
  3. Missouri
  4. Jackson
  5. Family Medicine
  6. NPI Profile

JACKSON MEDICAL CENTER PC
NPI 1508048125
Family Medicine in Jackson, MO

Active since December 05, 2007
2387 W JACKSON BLVD, JACKSON, MO 63755(573) 243-9288(573) 204-7074 Get Directions Write a Review

NPPES record last updated: October 7, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 7, 2020, Oct 10, 2016 (2 updates tracked since 2016).

About Jackson Medical Center Pc NPPES

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

JACKSON MEDICAL CENTER PC (NPI 1508048125) is a healthcare organization registered as a family medicine in Jackson, Missouri and active in the NPI registry since December 2007. The organization lists Stacey L Cantrell, Manager, as its authorized official.

NPPES Registry Identity

NPI1508048125
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameJACKSON MEDICAL CENTER PC
Location Address2387 W JACKSON BLVDJackson, MO 63755-3024
Mailing Address2387 W Jackson BlvdJackson, MO 63755-3024 · (573) 243-9288 · Fax (573) 204-7074
Phone(573) 243-9288
Fax(573) 204-7074
Organization SubpartNo
Authorized OfficialStacey L CantrellManager · (573) 335-1779
Enumeration DateDecember 5, 2007
Last NPPES UpdateOctober 7, 20202 updates tracked since enumeration
NPPES CertifiedOctober 7, 2020
✔ NPI 1508048125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
2387 W JACKSON BLVD, Jackson, MO 63755
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackson Medical Center Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jackson Medical Center PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Charles Pewitt, DO
Family Practice
NPI 1740389980
2387 W JACKSON BLVD
Jackson, MO 63755
(573) 243-9288
✔ PECOS✔ Accepts MedicareSame address

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

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 Jackson Medical Center PC's NPI number?

The NPI number for Jackson Medical Center PC is 1508048125. It was assigned to this organization in the NPPES registry on December 5, 2007.

Where is Jackson Medical Center PC located?

Jackson Medical Center PC is located at 2387 W Jackson Blvd, Jackson, MO 63755. The listed phone number is (573) 243-9288.

What is Jackson Medical Center PC's specialty?

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

Is Jackson Medical Center PC enrolled in Medicare?

Yes. Jackson Medical Center PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jackson Medical Center PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Jackson Medical Center PC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Jackson Medical Center PC accept?

Health plans from Anthem Blue Cross and Blue Shield list Jackson Medical Center PC 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.

When was this NPI record last updated?

The NPPES record for Jackson Medical Center PC was last updated on October 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.