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DAVID ALAN JACKSON MD
NPI 1962081455
Emergency Medicine in Montgomery, OH

Active since April 03, 2021PECOS Enrolled
10500 MONTGOMERY RD, MONTGOMERY, OH 45242(513) 865-1200(513) 558-5791 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 1, 2025, May 13, 2024, Apr 3, 2021 (3 updates tracked since 2021).

About David Alan Jackson Md NPPES

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

DAVID ALAN JACKSON MD (NPI 1962081455) is an individual emergency medicine provider in Montgomery, Ohio, licensed in Ohio (35.150662) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962081455
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDAVID ALAN JACKSONCredential: MD
Location Address10500 MONTGOMERY RDMontgomery, OH 45242-4402
Mailing Address10500 Montgomery RdMontgomery, OH 45242-4402 · (513) 865-1307
Phone(513) 865-1200
Fax(513) 558-5791
Sole ProprietorNo
Enumeration DateApril 3, 2021
Last NPPES UpdateJuly 1, 20253 updates tracked since enumeration
NPPES CertifiedJuly 1, 2025
✔ NPI 1962081455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in OH · 35.150662
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
10500 MONTGOMERY RD, Montgomery, OH 45242
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

David Alan Jackson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

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

Qualified Emergency Specialists Inc
Same address
Emergency Medicine
10500 MONTGOMERY RD
Montgomery, OH 45242
  • Reassigned Medicare billing, Ohio enrollment
  • 119 clinicians in this Medicare group
NPI 1700872728 (513) 865-1307
Talawanda Emergency Physicians, Inc.
28 mi
Emergency Medicine
110 N POPLAR ST
Oxford, OH 45056
  • Reassigned Medicare billing, Ohio enrollment
  • 21 clinicians in this Medicare group
NPI 1265416804 (513) 524-5353

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
13 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45242 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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.

DRAKE A SECCURRO MD
Hospitalist
10500 MONTGOMERY RD
MONTGOMERY, OH 45242
Hamilton County (513) 865-2246
GREGORIO MICELI DPM
Student in an Organized Health Care Education/Training Program
10500 MONTGOMERY RD
MONTGOMERY, OH 45242
Hamilton County (513) 865-1111
BENJAMIN BETHAY
Student in an Organized Health Care Education/Training Program
10500 MONTGOMERY RD
MONTGOMERY, OH 45242
Hamilton County (513) 865-1111
SMITH BEARELLY MD
Hospitalist
10500 MONTGOMERY RD
CINCINNATI, OH 45242
Hamilton County (513) 865-2246
VICTOR KOMLA DOE
Pharmacist
10500 MONTGOMERY RD
MONTGOMERY, OH 45242
Hamilton County (513) 865-1184
REGENCY HOSPITAL OF CINCINNATI, LLC
Internal Medicine
10500 MONTGOMERY RD
CINCINNATI, OH 45242
Hamilton County (717) 972-1100
SYED SHAD MAHMOOD
Internal Medicine (Critical Care Medicine)
10500 MONTGOMERY RD
MONTGOMERY, OH 45242
Hamilton County (513) 865-2246
DAVID A. FENWICK P.A.-C
Physician Assistant
10500 MONTGOMERY RD
CINCINNATI, OH 45242
Hamilton County (514) 865-1111

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 David Jackson's NPI number?

The NPI number for David Jackson is 1962081455. It was assigned to this individual provider in the NPPES registry on April 3, 2021.

Where is David Jackson located?

David Jackson practices at 10500 Montgomery Rd, Montgomery, OH 45242. The listed phone number is (513) 865-1200.

What is David Jackson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is David Jackson enrolled in Medicare?

Yes. David Jackson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for David Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), David Jackson reassigns Medicare benefits to 2 organizations: Qualified Emergency Specialists Inc (Montgomery, OH) and Talawanda Emergency Physicians, Inc. (Oxford, OH). 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 David Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for David Jackson was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.