MS. LISA CHANEL JACKSON M.D.
NPI 1912923996
Obstetrics & Gynecology in Beaufort, SC

Q: What is Lisa Jackson's NPI number?

The NPI number for Lisa Jackson is 1912923996. It was assigned to this individual provider in the NPPES registry on July 14, 2006.

Q: What is Lisa Jackson's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Jackson was last updated on June 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since July 14, 2006PECOS EnrolledAccepts Medicare Assignment

1264 RIBAUT RD STE 200, BEAUFORT, SC 29902(843) 987-7400 Get Directions Write a Review

NPPES record last updated: June 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Ms. Lisa Chanel Jackson M.d. NPPES

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

MS. LISA CHANEL JACKSON M.D. (NPI 1912923996) is an individual obstetrics & gynecology provider in Beaufort, South Carolina, licensed in South Carolina (33355) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Hampton Regional Medical Center, and maintains a secondary practice location in Orangeburg.

NPPES Registry Identity

NPI1912923996

Entity TypeIndividualFemale

Primary Taxonomy207V00000X

Provider Legal NameMS. LISA CHANEL JACKSONCredential: M.D.

Location Address1264 RIBAUT RD STE 200Beaufort, SC 29902-6127

Mailing AddressPo Box 357Ridgeland, SC 29936-2605 · (843) 987-7400

Phone(843) 987-7400

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateJuly 14, 2006

Last NPPES UpdateJune 13, 2026

NPPES CertifiedJune 13, 2026

✔ NPI 1912923996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

Licenses✔ Licensed in SC · 33355✔ Licensed in IL · 036113699

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

1264 RIBAUT RD STE 200, Beaufort, SC 29902

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Secondary Practice Location 1

Location 13310 Magnolia StOrangeburg, SC 29115-1466 · Phone (803) 531-6900 · Fax (803) 531-6907

Other Identifiers 2

Medicaid036113699IL

Medicaid33352SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, First Choice Next.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

Ms. Lisa Chanel Jackson M.d. 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 ID6800814245

PECOS Enrollment IDI20110715000101, I20150318001879

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.

Hospital Affiliations CMS Care Compare

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

Hampton Regional Medical Center

Acute Care Hospitals · Varnville, SC

OwnershipVoluntary non-profit - Private

CMS Certification Number420072

Location595 West Carolina AvenueVarnville, SC 29944 · Hampton County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29902 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

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

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.

Other Providers at the Same Location NPPES 5

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

GREGORY L GLOVER MD

Obstetrics & Gynecology