CAMERON JACKSON (DPT) – Physical Therapist, NPI 1700509247

CAMERON JACKSON (DPT) is a healthcare provider. based in Syracuse, Kansas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 11-06988 (KS). The NPI Number for CAMERON JACKSON (DPT) is 1700509247

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
CAMERON JACKSON (DPT)
NPI
1700509247
Phone
(620) 282-3636
Address
PO BOX 542
Enumeration Date
20 September 2022
Last Update Date
24 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7855944894
Graduation Year
2022 (4 years ago)
PAC ID
2961902051
Group Practice PAC ID
2062461403
Professional Enrollment ID
I20250822003591
Address ID
KS660065200BA603XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

1,046 PHYSICAL THERAPIST IN PRIVATE PRACTICE in KS

Provider Addresses for CAMERON JACKSON (DPT)

  • PO BOX 542

    SYRACUSE, KS 678780542

    Phone: (620) 282-3636

    Type: Mailing

  • 700 N HUSER ST

    SYRACUSE, KS 678787700

    Phone: (620) 384-7462

    Fax: (620) 384-6679

    Type: Location

  • 603 AMES ST

    BALDWIN CITY, KS 660065200

    Phone: (785) 594-4894

    Fax: (786) 594-2597

    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: 2025-08-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20250822003591IPhysical Therapist In Private PracticeKSTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 67878)

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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: 2062461403View full group profile
NameSpecialtyState
C H I R O P R A C T I CKS
C H I R O P R A C T I CKS
C H I R O P R A C T I CKS

Reviews

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Frequently asked questions

Does CAMERON JACKSON (DPT) have a public NPI I can cite?
Public records show CAMERON JACKSON (DPT) under NPI 1700509247.
Quick check: is CAMERON JACKSON (DPT) active?
Public NPPES data shows CAMERON JACKSON (DPT) with an active NPI status right now.
What does the directory say CAMERON JACKSON (DPT) does?
Insurance directories may phrase it differently, but here CAMERON JACKSON (DPT) maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
Which community is linked to CAMERON JACKSON (DPT)?
CAMERON JACKSON (DPT) shows a connection to Syracuse, Kansas in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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