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KENDRA JOY JACKSON MD
NPI 1649776469
Pediatrics - Pediatric Emergency Medicine in Baltimore, MD

Active since April 02, 2018PECOS Enrolled
1800 ORLEANS ST, BALTIMORE, MD 21287(410) 955-5000 Get Directions Write a Review

NPPES record last updated: September 6, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 6, 2024, Aug 5, 2024, Apr 12, 2024 and 9 more (12 updates tracked since 2021).

About Kendra Joy Jackson Md NPPES

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

KENDRA JOY JACKSON MD (NPI 1649776469) is an individual pediatric emergency medicine provider in Baltimore, Maryland, licensed in Maryland (D0099966) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Baltimore.

NPPES Registry Identity

NPI1649776469
Entity TypeIndividualFemale
Primary Taxonomy2080P0204X
Provider Legal NameKENDRA JOY JACKSONCredential: MD
Location Address1800 ORLEANS STBaltimore, MD 21287-0010
Mailing Address6201 Greenleigh AveMiddle River, MD 21220-2004 · (410) 933-6423 · Fax (410) 500-4266
Phone(410) 955-5000
Sole ProprietorNo
Enumeration DateApril 2, 2018
Last NPPES UpdateSeptember 6, 202412 updates tracked since enumeration
NPPES CertifiedSeptember 6, 2024
✔ NPI 1649776469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in MD · D0099966
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
Also ListedPediatricsTaxonomy 208000000X · License D0099966 (MD)
1800 ORLEANS ST, Baltimore, MD 21287
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Secondary Practice Location 1

Location 1600 N Wolfe StBaltimore, MD 21287-0005 · Phone (410) 955-5000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kendra Joy 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.

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.

KATHRYN ROSENBLATT M.D.
Anesthesiology
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 955-7461
DR. CARMEL BOGLE M.D.
Pediatrics
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (443) 287-0526
MIAN MOHAMMAD BILAL KHALID MD
Internal Medicine (Gastroenterology)
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 955-5000
SPENCER WILSON
Surgery (Trauma Surgery)
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 933-6423
EVAN FOX
Radiology (Neuroradiology)
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 955-5000
ADAM ROBERT BUSSELLS
Physician Assistant
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 955-5000
DR. SARAH WALSER MD
Student in an Organized Health Care Education/Training Program
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (484) 883-6433
LYNN DESROSIERS FNP-C
Nurse Practitioner (Family)
1800 ORLEANS ST
BALTIMORE, MD 21287
Baltimore City (410) 955-2800

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 Kendra Jackson's NPI number?

The NPI number for Kendra Jackson is 1649776469. It was assigned to this individual provider in the NPPES registry on April 2, 2018.

Where is Kendra Jackson located?

Kendra Jackson practices at 1800 Orleans St, Baltimore, MD 21287. The listed phone number is (410) 955-5000.

What is Kendra Jackson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Kendra Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Kendra Jackson was last updated on September 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.