KENNETH G JACKSON JR. MD
NPI 1801183710
Family Medicine in Clemson, SC

Q: What is Kenneth Jackson's NPI number?

The NPI number for Kenneth Jackson is 1801183710. It was assigned to this individual provider in the NPPES registry on June 30, 2011.

Q: What is Kenneth Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kenneth Jackson was last updated on December 1, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 30, 2011PECOS EnrolledAccepts Medicare Assignment

96.08/100

CMS Quality Rating

885 TIGER BLVD, CLEMSON, SC 29631(864) 654-2067(864) 653-5926 Get Directions Write a Review

NPPES record last updated: December 1, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Kenneth G Jackson Jr. Md NPPES

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

KENNETH G JACKSON JR. MD (NPI 1801183710) is an individual family medicine provider in Clemson, South Carolina, licensed in South Carolina (LL33560) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with Prisma Health Oconee Memorial Hospital, and maintains a secondary practice location in Clemson.

NPPES Registry Identity

NPI1801183710

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameKENNETH G JACKSON JR.Credential: MD

Location Address885 TIGER BLVDClemson, SC 29631-1480

Mailing AddressPo Box 100174Columbia, SC 29202-3174 · (864) 512-5725 · Fax (864) 512-8039

Phone(864) 654-2067

Fax(864) 653-5926

Sole ProprietorNo

Medical School CMSUniversity Of North Carolina At Chapel Hill School Of MedicineGraduated 2011

Enumeration DateJune 30, 2011

Last NPPES UpdateDecember 1, 2022

NPPES CertifiedDecember 1, 2022

✔ NPI 1801183710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in SC · LL33560

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.

885 TIGER BLVD, Clemson, SC 29631

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Secondary Practice Location 1

Location 1895 Tiger BlvdClemson, SC 29631 · Phone (864) 512-7257 · Fax (864) 654-7672

Other Identifiers 1

Medicaid335603SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include First Choice Next, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kenneth G Jackson Jr. Md 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 ID1355577354

PECOS Enrollment IDI20131121001732

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.

Areas of Expertise CMS Part B claims 18

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.

Established patient office or other outpatient visit, 30-39 minutes 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

599 services297 patients

Established patient office or other outpatient visit, 20-29 minutes 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

491 services314 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

314 services314 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

304 services304 patients

Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage 90686

The quadrivalent influenza vaccine is a shot to protect you from four different flu viruses. It's preservative-free and given in a 0.5 ml dose. It helps your body build immunity to the flu, reducing your risk of getting sick.

126 services125 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

126 services125 patients

Fee covid-19 vac 13 res 0124A

The "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.

82 services82 patients

Established patient office or other outpatient visit, 10-19 minutes 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

68 services62 patients

Established patient office or other outpatient visit, 40-54 minutes 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

42 services32 patients

Adm sarscv2 30mcg trs-sucr b 0054A

This service involves the administration of a 30mcg dose of the SARS-CoV-2 vaccine, which helps protect against COVID-19. The 'trs-sucr b' indicates it's stabilized with sugars for effectiveness. It's a crucial step in maintaining your health during the pandemic.

36 services36 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

29 services29 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

21 services18 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

19 services17 patients

Injection, methylprednisolone acetate, 40 mg J1030

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

17 services12 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

16 services12 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

13 services13 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

12 services12 patients

Adm sarscv2 30mcg trs-sucr 1 0051A

This is a procedure for administering the SARS-CoV-2 vaccine. The "30mcg" refers to the dosage of the vaccine, and "trs-sucr" is a component in the vaccine. The vaccine helps your body develop immunity to the COVID-19 virus to prevent illness.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Prisma Health Oconee Memorial Hospital

Acute Care Hospitals · Seneca, SC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420009

Location298 Memorial DrSeneca, SC 29672 · Oconee County

Emergency services Birthing friendly

Anmed Health

Acute Care Hospitals · Anderson, SC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420027

Location800 N Fant StAnderson, SC 29621 · Anderson County

Emergency services Birthing friendly

Prisma Health Greenville Memorial Hospital

Acute Care Hospitals · Greenville, SC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420078

Location701 Grove RoadGreenville, SC 29605 · Greenville County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29631 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

Most-billed visit code 99214

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.

96.08/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

92.17

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers29 claims105 services$6.54 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

5 suppliers13 claims29 services$1.13 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$36.20 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers14 claims14 services$5.02 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

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

PATTIE B BURRISS APRN

Nurse Practitioner