DR. JOHN RONALD JACKSON (M.D.) – Obstetrics & Gynecology Physician, NPI 1114922911
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
630 OBSTETRICS/GYNECOLOGY in KY
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Provider Addresses for DR. JOHN RONALD JACKSON (M.D.)
20, Medical Village Drive, Edgewood, Kenton County, Kentucky, 41017, United States
STE 302
EDGEWOOD, KY 410175402
Phone: (859) 341-2510
Fax: (859) 578-5888
Type: Location
Reading Road, Avondale, Cincinnati, Hamilton County, Ohio, 45229-3018, United States
SUITE 150
CINCINNATI, OH 452021454
Phone: (513) 721-3200
Fax: (513) 639-3186
Type: Mailing
PO BOX 635283
CINCINNATI, OH 452635283
Phone: (859) 341-2510
Fax: (859) 578-2004
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $358.
Total Amount is formed as General ($358) + Research ($0) + Ownership ($0) = $358.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Hologic Sales and Service, LLC ($90).
Total Amount
$358
General + Research + Ownership
Payments
11
Total payment records
General Amount
$358
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2010-01-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100119000069 | I | Obstetrics/Gynecology | KY | TBD |
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.
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 41017)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | KY | |
| Family Practice | OH | |
| H O S P I T A L I S T | OH | |
| Family Practice | KY | |
| Family Practice | OH | |
| G A S T R O E N T E R O L O G Y | KY | |
| - | KY | |
| Family Practice | OH | |
| - | FL | |
| Nurse Practitioner | KY |
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