DR. KRISTEN B JACKSON (PH.D.) – Rehabilitation Psychologist, NPI 1164760500

DR. KRISTEN B JACKSON (PH.D.) is a healthcare provider. based in Columbus, Ohio. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. The NPI Number for DR. KRISTEN B JACKSON (PH.D.) is 1164760500

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
DR. KRISTEN B JACKSON (PH.D.)
NPI
1164760500
Phone
(614) 293-3830
Address
480 MEDICAL CENTER DR
Enumeration Date
18 January 2013
Last Update Date
18 January 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6142937604
Graduation Year
2011 (15 years ago)
PAC ID
4082851589
Group Practice PAC ID
7012960644
Professional Enrollment ID
I20130430000307
Address ID
OH432101229CO480XXDRXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness75
Years active:13State licenses:0Digital endpointsOther names

1,139 CLINICAL PSYCHOLOGIST in OH

Provider Addresses for DR. KRISTEN B JACKSON (PH.D.)

  • 480 MEDICAL CENTER DR

    DODD HALL 2145

    COLUMBUS, OH 432101229

    Phone: (614) 293-3830

    Fax: (614) 293-4870

    Mailing address matches the actual address.

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: 2013-04-30

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
I20130430000307IClinical PsychologistOHTBD

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
90837Psychotherapy, 1 hour6512$0
View full utilization report →

Insurance plans in this area (ZIP 43210)

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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: 7012960644View full group profile
NameSpecialtyState
Physical Medicine And RehabilitationOH
Clinical PsychologistOH
Clinical PsychologistOH
Physical Medicine And RehabilitationCT
-OH
Physical Medicine And RehabilitationOH
Clinical PsychologistOH
Nurse PractitionerOH
Clinical PsychologistOH
Physical Medicine And RehabilitationPA

Reviews

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Frequently asked questions

Can I use this page to confirm DR. KRISTEN B JACKSON (PH.D.)'s NPI?
Yes. DR. KRISTEN B JACKSON (PH.D.) is listed with NPI 1164760500 in the public NPI dataset.
Does the file indicate DR. KRISTEN B JACKSON (PH.D.) is practicing under active NPI?
Directory data currently reports DR. KRISTEN B JACKSON (PH.D.) as active.
What is DR. KRISTEN B JACKSON (PH.D.) best known for clinically?
Directory data describes DR. KRISTEN B JACKSON (PH.D.) with Rehabilitation Psychologist. Clinical services aligned with this taxonomy classification.
What area does DR. KRISTEN B JACKSON (PH.D.) serve?
DR. KRISTEN B JACKSON (PH.D.)'s listing highlights Columbus, Ohio; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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