DAVID JACKSON (M.D.) – Emergency Medicine Physician, NPI 1033195607

DAVID JACKSON (M.D.) is a healthcare provider. based in Beavercreek, Ohio. specializing in EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. 35059981J (OH). The NPI Number for DAVID JACKSON (M.D.) is 1033195607

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
DAVID JACKSON (M.D.)
NPI
1033195607
Phone
(937) 702-4500
Address
3535 Pentagon Blvd
Enumeration Date
15 December 2005
Last Update Date
25 July 2019

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
3308091801
Graduation Year
1986 (40 years ago)
PAC ID
7618934936
Group Practice PAC ID
7315851359
Professional Enrollment ID
I20041217000325
Address ID
OH446460000MA870XXNEXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,673 EMERGENCY MEDICINE in OH

Provider Addresses for DAVID JACKSON (M.D.)

  • 3535 Pentagon Blvd

    Beavercreek, OH 454311705

    Phone: (937) 702-4500

    Type: Location

  • 3535 Southern Blvd

    Kettering, OH 454291221

    Phone: (937) 395-8166

    Type: Location

  • 600 W Main St

    Troy, OH 453732928

    Phone: (937) 980-7010

    Fax: (937) 980-7019

    Type: Location

  • 6147 State Route 122

    Middletown, OH 450055201

    Phone: (513) 261-3410

    Fax: (513) 261-3419

    Type: Location

  • 4000 Miamisburg Centerville Rd

    Miamisburg, OH 453427615

    Phone: (937) 384-8791

    Fax: (937) 384-8729

    Type: Location

  • 1997 Miamisburg Centerville Rd

    Centerville, OH 454593811

    Phone: (937) 401-6228

    Fax: (937) 401-6447

    Type: Location

  • 8701 Old Troy Pike

    Huber Heights, OH 454241066

    Phone: (937) 558-3338

    Fax: (937) 558-3349

    Type: Location

  • 450 Washington Jackson Rd Ste F

    Eaton, OH 453208699

    Phone: (937) 456-8376

    Fax: (937) 456-8377

    Type: Location

  • 405 W Grand Ave

    Dayton, OH 454057538

    Phone: (937) 723-3211

    Fax: (937) 723-4609

    Type: Location

  • 100 Kettering Way

    Franklin, OH 450051155

    Phone: (937) 458-4700

    Fax: (937) 458-4737

    Type: Location

  • 1141 N Monroe Dr

    Xenia, OH 453851619

    Phone: (937) 352-2500

    Fax: (937) 352-3501

    Type: Location

  • Saint Elizabeth Youngstown Hospital, 1044, Belmont Avenue, Arlington Heights, North Side, Youngstown, Mahoning County, Ohio, 44501, United States

    YOUNGSTOWN, OH 445041006

    Phone: (330) 746-7211

    Fax: (330) 656-5901

    Type: Location

  • 5700, Darrow Road, Hudson, Summit County, Ohio, 44236, United States

    SUITE 106

    HUDSON, OH 442365021

    Phone: (330) 656-5911

    Fax: (330) 656-5901

    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: 2004-12-17

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
I20041217000325IEmergency MedicineOHTBD

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
99284Emergency department visit with moderate level of medical decision making2321$0
View full utilization report →

Insurance plans in this area (ZIP 45431)

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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: 7315851359View full group profile
NameSpecialtyState
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
-OH
-OH
Emergency MedicineOH

Reviews

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Frequently asked questions

What is the registry number for DAVID JACKSON (M.D.)?
The registry entry for DAVID JACKSON (M.D.) shows NPI 1033195607.
Does the public listing show DAVID JACKSON (M.D.) as active?
DAVID JACKSON (M.D.)'s NPI record reflects an active status in NPPES.
Which specialty label fits DAVID JACKSON (M.D.)?
NPPES ties DAVID JACKSON (M.D.) to Emergency Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to DAVID JACKSON (M.D.)?
The directory associates DAVID JACKSON (M.D.) with Beavercreek, Ohio. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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