SHAWN BARRETT JACKSON (M,D,) – Anatomic Pathology & Clinical Pathology Physician, NPI 1730258708

SHAWN BARRETT JACKSON (M,D,) is a healthcare provider. based in Bloomington, Illinois. specializing in PATHOLOGY. They hold the professional credentials M,D,. They hold a License No. 2005005716 (MO). The NPI Number for SHAWN BARRETT JACKSON (M,D,) is 1730258708

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
SHAWN BARRETT JACKSON (M,D,)
NPI
1730258708
Phone
(309) 533-7070
Address
3302 Gerig Dr Ste 100
Enumeration Date
6 November 2006
Last Update Date
2 January 2026

Doctor Profile

Medical School Name
UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, AURORA
Secondary Phone
3095337070
Graduation Year
1998 (28 years ago)
PAC ID
0446153514
Group Practice PAC ID
2668821919
Professional Enrollment ID
I20260107002685
Address ID
IL617046343BL3302XDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness85
Years active:19State licenses:1Digital endpointsOther names

766 PATHOLOGY in IL

Provider Addresses for SHAWN BARRETT JACKSON (M,D,)

  • 3302 Gerig Dr Ste 100

    Bloomington, IL 617046343

    Phone: (309) 533-7070

    Fax: (855) 710-6552

    Type: Location

  • 1587 N Bolton Ave Ste 1300

    Alexandria, LA 713034255

    Phone: (318) 933-3376

    Fax: (318) 933-3377

    Type: Location

  • 1230 E Kingsley St Ste A&b

    Springfield, MO 658047211

    Phone: (417) 336-0033

    Fax: (855) 710-6552

    Type: Location

  • 550, East Primrose Street, Springfield, Greene County, Missouri, 65807, United States

    SPRINGFIELD, MO 658075180

    Phone: (417) 269-4646

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-01-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050519000011IPathologyMOTBD
I20251230001333IPathologyLATBD
I20260107002685IPathologyILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
88305Pathology examination of tissue using a microscope, intermediate complexity7,5924,630$0
88304Pathology examination of tissue using a microscope, moderately low complexity358322$0
88341Special stained specimen slides to examine tissue, each additional procedure17361$0
88342Special stained specimen slides to examine tissue, initial procedure125104$0
88307Pathology examination of tissue using a microscope, moderately high complexity8956$0
View full utilization report →

Insurance plans in this area (ZIP 61704)

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Provider's Procedures

SHAWN BARRETT JACKSON (M,D,) performs procedures in PATHOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PATHOLOGYMO88304Pathology examination of tissue using a microscope, moderately low complexity220105
PATHOLOGYMO88312Special stained specimen slides to identify organisms including interpretation and report6250
PATHOLOGYMO88342Tissue or cell analysis by immunologic technique2523

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2668821919View full group profile
NameSpecialtyState
Dermatology, Micrographic Dermatologic Surgery (Mds), DermatologyIL
D E R M A T O L O G YIL
Dermatology, Micrographic Dermatologic Surgery (Mds)MO
Physician AssistantIL
Physician AssistantIL
Physician AssistantIL

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Frequently asked questions

Where can patients find SHAWN BARRETT JACKSON (M,D,)'s NPI?
You can confirm SHAWN BARRETT JACKSON (M,D,) with NPI 1730258708; it appears in the national provider directory.
Does this profile mean SHAWN BARRETT JACKSON (M,D,) is currently active?
Yes — SHAWN BARRETT JACKSON (M,D,) appears active in the national provider directory.
What does SHAWN BARRETT JACKSON (M,D,) treat or focus on?
Patients typically see SHAWN BARRETT JACKSON (M,D,) under the specialty Anatomic Pathology & Clinical Pathology Physician. Clinical services aligned with this taxonomy classification.
Does SHAWN BARRETT JACKSON (M,D,) practice in Illinois?
You will see Bloomington, Illinois on file for SHAWN BARRETT JACKSON (M,D,) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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