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CAROL D JACKSON D.D.S
NPI 1649496910
Dentist in Danville, IL

Active since April 17, 2007PECOS Enrolled
614 N GILBERT ST, DANVILLE, IL 61832(217) 442-8790(217) 442-8780 Get Directions Write a Review

NPPES record last updated: September 19, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Carol D Jackson D.d.s NPPES

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

CAROL D JACKSON D.D.S (NPI 1649496910) is an individual dentist in Danville, Illinois, licensed in Maryland (14764) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649496910
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameCAROL D JACKSONCredential: D.D.S
Location Address614 N GILBERT STDanville, IL 61832-3940
Mailing Address208 Crain Highway, SouthwestGlen Burnie, MD 21061 · (310) 498-0002
Phone(217) 442-8790
Fax(217) 442-8780
Sole ProprietorYes
Enumeration DateApril 17, 2007
Last NPPES UpdateSeptember 19, 2012
✔ NPI 1649496910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Licenses✔ Licensed in MD · 14764✔ Licensed in IL · 019023180
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
614 N GILBERT ST, Danville, IL 61832
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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carol D Jackson D.d.s 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.

Medicare Billing Reassignment

Medicare enrollment records show Carol Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Fetter Health Care Network Inc
628 mi
Federally Qualified Health Center (FQHC)
1681 OLD HIGHWAY 6
Cross, SC 29436
  • Reassigned Medicare billing, South Carolina enrollment
  • Also billed through NPI 1982124301 (South Carolina)
  • 79 clinicians in this Medicare group
NPI 1396859823 (843) 753-2334

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61832 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
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.

Other Providers at the Same Location NPPES 7

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

GARY L BURNS MA, LCPC
Counselor
614 N GILBERT ST
DANVILLE, IL 61832
Vermilion County (217) 442-8564
AUNT MARTHA'S HEALTH AND WELLNESS, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
614 N GILBERT ST
DANVILLE, IL 61832
Vermilion County (877) 692-8686
MR. DARREN J YORK MA, LCPC
Counselor (Professional)
614 N GILBERT ST
DANVILLE, IL 61832
Vermilion County (217) 442-8790
MRS. SAMANTHA RENAE MCLAUGHLIN RDH
Dental Hygienist
614 N GILBERT ST
DANVILLE, IL 61832
Vermilion County (217) 442-8790
DR. EDDIE Y RAMIREZ MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
614 N GILBERT ST
DANVILLE, IL 61832
Vermilion County (708) 747-7100
ALINE DENISE NELSON FNP
Nurse Practitioner (Family)
614 N GILBERT ST
DANVILLE, IL 61832
Vermilion County (877) 692-8686
AMY LAMB
Dental Hygienist
614 N GILBERT ST
DANVILLE, IL 61832
Vermilion County (708) 754-1044

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 Carol Jackson's NPI number?

The NPI number for Carol Jackson is 1649496910. It was assigned to this individual provider in the NPPES registry on April 17, 2007.

Where is Carol Jackson located?

Carol Jackson practices at 614 N Gilbert St, Danville, IL 61832. The listed phone number is (217) 442-8790.

What is Carol Jackson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Carol Jackson enrolled in Medicare?

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

Which organization bills Medicare for Carol Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carol Jackson reassigns Medicare benefits to Fetter Health Care Network Inc (Cross, SC). The 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 Carol Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carol Jackson accept?

Health plans from Anthem Blue Cross and Blue Shield and Guardian list Carol 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.

When was this NPI record last updated?

The NPPES record for Carol Jackson was last updated on September 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.