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MR. JACKSON W MCKIM CAA
NPI 1902779051
Anesthesiologist Assistant in Saint Louis, MO

Active since September 25, 2025Accepts Medicare Assignment
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141(314) 251-6000(636) 386-7679 Get Directions Write a Review

NPPES record last updated: September 25, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Mr. Jackson W Mckim Caa NPPES

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

MR. JACKSON W MCKIM CAA (NPI 1902779051) is an individual anesthesiologist assistant in Saint Louis, Missouri, licensed in Missouri (PENDING) and active in the NPI registry since September 2025. He is affiliated with Mercy Hospital St Louis and is a graduate of Emory University School Of Medicine (2025).

NPPES Registry Identity

NPI1902779051
Entity TypeIndividualMale
Primary Taxonomy367H00000X
Provider Legal NameMR. JACKSON W MCKIMCredential: CAA
Location Address615 S NEW BALLAS RDSaint Louis, MO 63141-8221
Mailing Address339 Consort DrBallwin, MO 63011-4439 · (636) 386-9224 · Fax (636) 386-7679
Phone(314) 251-6000
Fax(636) 386-7679
Sole ProprietorNo
Medical School CMSEmory University School Of MedicineGraduated 2025
Enumeration DateSeptember 25, 2025
NPPES CertifiedSeptember 25, 2025
✔ NPI 1902779051 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367H00000X
License✔ Licensed in MO · PENDING
Definition
An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.
615 S NEW BALLAS RD, Saint Louis, MO 63141
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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

Mr. Jackson W Mckim Caa 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 ID6800375916
PECOS Enrollment IDI20260210000374

Hospital Affiliations CMS Care Compare

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

Mercy Hospital St Louis

Acute Care Hospitals · Saint Louis, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number260020
Location615 New Ballas RoadSaint Louis, MO 63141 · St. Louis County
Emergency services Birthing friendly

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.

MRS. PATRICIA ANN RICE APN
Nurse Practitioner (Family)
615 S NEW BALLAS RD
SAINT LOUIS, MO 63141
St. Louis County (314) 251-6339
MARY BETH WALKER FNP
Nurse Practitioner (Family)
615 S NEW BALLAS RD
SAINT LOUIS, MO 63141
St. Louis County (314) 251-6000
LOVEPREET SINGH RANDHAWA MD
Internal Medicine
615 S NEW BALLAS RD
SAINT LOUIS, MO 63141
St. Louis County (314) 251-6339
DR. CONNOR ROBERT REIS DO
Internal Medicine
615 S NEW BALLAS RD
SAINT LOUIS, MO 63141
St. Louis County (314) 251-6930
MR. SHEBY THOMAS AA-S
Anesthesiologist Assistant
615 S NEW BALLAS RD, DEPT OF ANESTHESIOLOGY
SAINT LOUIS, MO 63141
St. Louis County (636) 386-9224
JOSE L OLIVER SEGARRA
Dentist (General Practice)
615 S NEW BALLAS RD
SAINT LOUIS, MO 63141
St. Louis County (314) 251-6382
CAREN BIRKENKAMP PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
615 S NEW BALLAS RD
SAINT LOUIS, MO 63141
St. Louis County (314) 251-6000
ANAS M HASIC MD
Internal Medicine
615 S NEW BALLAS RD
SAINT LOUIS, MO 63141
St. Louis County (314) 509-5305

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 Jackson Mckim's NPI number?

The NPI number for Jackson Mckim is 1902779051. It was assigned to this individual provider in the NPPES registry on September 25, 2025.

Where is Jackson Mckim located?

Jackson Mckim practices at 615 S New Ballas Rd, Saint Louis, MO 63141. The listed phone number is (314) 251-6000.

What is Jackson Mckim's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Jackson Mckim enrolled in Medicare?

Yes. Jackson Mckim 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.

Is Jackson Mckim affiliated with any hospitals?

According to CMS data, Jackson Mckim is affiliated with Mercy Hospital St Louis.

When was this NPI record last updated?

The NPPES record for Jackson Mckim was last updated on September 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.