1. Home
  2. Directory
  3. Texas
  4. Dallas
  5. Nurse Anesthetist Certified Registered
  6. NPI Profile

KEVIN JACKSON SR. CRNA
NPI 1790230837
Nurse Anesthetist, Certified Registered in Dallas, TX

Active since August 18, 2016Accepts Medicare Assignment
84.44/100
CMS Quality Rating
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240(972) 715-5000(972) 715-9976 Get Directions Write a Review

NPPES record last updated: January 5, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 5, 2017, Aug 18, 2016 (2 updates tracked since 2016).

About Kevin Jackson Sr. Crna NPPES

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

KEVIN JACKSON SR. CRNA (NPI 1790230837) is an individual nurse anesthetist, certified registered in Dallas, Texas, licensed in Texas (AP132899) and active in the NPI registry since August 2016. He is affiliated with Southeastern Regional Medical Center and is a graduate of Other (2016).

NPPES Registry Identity

NPI1790230837
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameKEVIN JACKSON SR.Credential: CRNA
Location Address6606 LBJ FWY, SUITE 200Dallas, TX 75240-6533
Mailing AddressPo Box 650865Dallas, TX 75265-0865 · (972) 715-5000 · Fax (972) 715-1996
Phone(972) 715-5000
Fax(972) 715-9976
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 18, 2016
Last NPPES UpdateJanuary 5, 20172 updates tracked since enumeration
✔ NPI 1790230837 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in TX · AP132899
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 862974 (TX)
6606 LBJ FWY, Dallas, TX 75240
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin Jackson Sr. Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7719269315
PECOS Enrollment IDI20171013000677

Medicare Billing Reassignments

2

Medicare enrollment records show Kevin Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Medstream Anesthesia PLLC
6.1 mi
Anesthesiology
2221 LAKESIDE BLVD STE 600
Richardson, TX 75082
  • Reassigned Medicare billing, North Carolina enrollment
  • 493 clinicians in this Medicare group
NPI 1649616160 (828) 210-9386
American Anesthesiology Of North Carolina, PLLC
1,009 mi
Nurse Anesthetist, Certified Registered
1236 HUFFMAN MILL RD, SUITE 2000
Burlington, NC 27215
  • Reassigned Medicare billing, North Carolina enrollment
  • 652 clinicians in this Medicare group
NPI 1053677195 (366) 585-1770

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for lens surgery 00142
Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.
13 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Southeastern Regional Medical Center

Acute Care Hospitals · Lumberton, NC
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340050
Location300 W 27 St PO Box 1408Lumberton, NC 28359 · Robeson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75240 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
$131.01 typical visit price
range $57.18 – $172.86
Typical copayment $32.75 (range $14.29 – $43.21)
Most-billed visit code 99204
Established Patient
$71.28 typical visit price
range $18.48 – $141.20
Typical copayment $17.82 (range $4.62 – $35.30)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.44/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality88.33
Improvement Activities40
Cost69.53

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.

ADAM PEEPLES CRNA
Nurse Anesthetist, Certified Registered
6606 LBJ FWY, SUITE 200
DALLAS, TX 75240
Dallas County (972) 715-5000
JEANNIE K MURPHY CRNA
Nurse Anesthetist, Certified Registered
6606 LBJ FWY, SUITE 200
DALLAS, TX 75240
Dallas County (972) 715-5000
MARSHALL ANDERSEN CRNA
Nurse Anesthetist, Certified Registered
6606 LBJ FWY, STE. 200
DALLAS, TX 75240
Dallas County (972) 715-5000
JORGE AVILA-HERNANDEZ MD
Anesthesiology
6606 LBJ FWY, STE. 200
DALLAS, TX 75240
Dallas County (972) 715-5000
WARREN CUSICK CRNA
Nurse Anesthetist, Certified Registered
6606 LBJ FWY, STE. 200
DALLAS, TX 75240
Dallas County (972) 715-5000
DR. SHANON M. COOKE MD
Anesthesiology
6606 LBJ FWY, SUITE 200
DALLAS, TX 75240
Dallas County (972) 715-5000
RONALD PRESTAGE CRNA
Nurse Anesthetist, Certified Registered
6606 LBJ FWY, SUITE 200
DALLAS, TX 75240
Dallas County (972) 715-5000
JONATHAN BLACKMORE PHILLIPS CRNA
Nurse Anesthetist, Certified Registered
6606 LBJ FWY, SUITE 200
DALLAS, TX 75240
Dallas County (972) 715-5000

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 1790230837. It was assigned to this individual provider in the NPPES registry on August 18, 2016.

Where is Kevin Jackson located?

Kevin Jackson practices at 6606 Lbj Fwy Suite 200, Dallas, TX 75240. The listed phone number is (972) 715-5000.

What is Kevin Jackson's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Kevin Jackson enrolled in Medicare?

Yes. Kevin Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kevin Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Jackson reassigns Medicare benefits to 2 organizations: Medstream Anesthesia PLLC (Richardson, TX) and American Anesthesiology Of North Carolina, PLLC (Burlington, NC). Each 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 Kevin Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Kevin Jackson affiliated with any hospitals?

According to CMS data, Kevin Jackson is affiliated with Southeastern Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Kevin Jackson was last updated on January 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.