Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KEELAN RAPHAEL JACKSON
NPI 1790449882
Military Health Care Provider - Independent Duty Corpsman in Parris Island, SC

Q: What is Keelan Jackson's NPI number?

The NPI number for Keelan Jackson is 1790449882. It was assigned to this individual provider in the NPPES registry on October 26, 2021.

Q: What is Keelan Jackson's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Keelan Jackson was last updated on August 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days 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.

Active since October 26, 2021

670 BOULEVARD DE FRANCE, PARRIS ISLAND, SC 29905(843) 228-4757 Get Directions Write a Review

NPPES record last updated: August 4, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Keelan Raphael Jackson NPPES

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

KEELAN RAPHAEL JACKSON (NPI 1790449882) is an individual independent duty corpsman provider in Parris Island, South Carolina, licensed in South Carolina (1790449882) and active in the NPI registry since October 2021.

NPPES Registry Identity

NPI1790449882

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameKEELAN RAPHAEL JACKSON

Location Address670 BOULEVARD DE FRANCEParris Island, SC 29905

Mailing Address670 Boulevard De FranceParris Island, SC 29905 · (843) 228-4757

Phone(843) 228-4757

Sole ProprietorNo

Enumeration DateOctober 26, 2021

Last NPPES UpdateAugust 4, 2026

NPPES CertifiedAugust 4, 2026

✔ NPI 1790449882 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

License✔ Licensed in SC · 1790449882

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

670 BOULEVARD DE FRANCE, Parris Island, SC 29905

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Other Providers at the Same Location NPPES 17

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

BYRON BARBOUR DPT

Military Health Care Provider

670 BOULEVARD DE FRANCE
PARRIS ISLAND, SC 29905

Beaufort County (843) 228-2505

ZACHARY ARGENTINE DDS

Dentist

670 BOULEVARD DE FRANCE, BLDG 674
MCRD PARRIS ISLAND, SC 29905

Beaufort County (843) 228-3500

DR. JOSEPH LANDON MCKINLEY DO

General Practice

670 BOULEVARD DE FRANCE
PARRIS ISLAND, SC 29905

Beaufort County (843) 228-5600

PAIGE DESAULNIERS P.A.

Physician Assistant

670 BOULEVARD DE FRANCE
PARRIS ISLAND, SC 29905

Beaufort County (843) 228-4237

TAMMY CARTER ATC

Specialist/Technologist (Athletic Trainer)

670 BOULEVARD DE FRANCE, SMART CLINIC
PARRIS ISLAND, SC 29905

Beaufort County (843) 228-2505

RYAN ANDRE MANALO MAGSINO DDS

Dentist

670 BOULEVARD DE FRANCE
BEAUFORT, SC 29905

Beaufort County (843) 228-3500

DANIELLE MELLER DDS

Dentist (General Practice)

670 BOULEVARD DE FRANCE
PARRIS ISLAND, SC 29905

Beaufort County (843) 228-3500

DR. ROBERT WILLIAM BANKOV M.D.

Emergency Medicine

670 BOULEVARD DE FRANCE
PARRIS ISLAND, SC 29905

Beaufort County (843) 228-2873

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 Keelan Jackson's NPI number?

The NPI number for Keelan Jackson is 1790449882. It was assigned to this individual provider in the NPPES registry on October 26, 2021.

Where is Keelan Jackson located?

Keelan Jackson practices at 670 Boulevard De France, Parris Island, SC 29905. The listed phone number is (843) 228-4757.

What is Keelan Jackson's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Keelan Jackson was last updated on August 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days 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.