DAVID ALAN JACKSON (MD) – Emergency Medicine Physician, NPI 1962081455

DAVID ALAN JACKSON (MD) is a healthcare provider. based in Montgomery, Ohio. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 35.150662 (OH). The NPI Number for DAVID ALAN JACKSON (MD) is 1962081455

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
DAVID ALAN JACKSON (MD)
NPI
1962081455
Phone
(513) 865-1307
Address
10500 MONTGOMERY RD
Enumeration Date
3 April 2021
Last Update Date
1 July 2025

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
5135245351
Graduation Year
2021 (5 years ago)
PAC ID
5597167999
Group Practice PAC ID
2062431471
Professional Enrollment ID
I20240624002997
Address ID
OH450561204OX110XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Digital endpointsOther names

2,673 EMERGENCY MEDICINE in OH

Provider Addresses for DAVID ALAN JACKSON (MD)

  • 10500 MONTGOMERY RD

    MONTGOMERY, OH 452424402

    Phone: (513) 865-1307

    Type: Mailing

  • 231 ALBERT SABIN WAY, MSB 1654, ML 0769

    UC EMERGENCY MEDICINE

    CINCINNATI, OH 452670769

    Phone: (513) 558-5281

    Fax: (513) 558-5791

    Type: Mailing

  • 234 GOODMAN STREET

    CENTER FOR EMERGENCY CARE

    CINCINNATI, OH 452190796

    Phone: (513) 558-5281

    Fax: (513) 558-5791

    Type: Location

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: 2024-06-24

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
I20240624002997IEmergency 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.

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

Insurance plans in this area (ZIP 45242)

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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: 2062431471View full group profile
NameSpecialtyState
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Emergency Medicine, Pediatric MedicineOH

Reviews

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Frequently asked questions

How do I look up DAVID ALAN JACKSON (MD) by NPI?
Use NPI 1962081455 when you need to reference DAVID ALAN JACKSON (MD) in forms, claims, or directories.
Is DAVID ALAN JACKSON (MD) currently active in the NPI registry?
CMS-published data lists DAVID ALAN JACKSON (MD) as an active registrant.
What does DAVID ALAN JACKSON (MD) treat or focus on?
Patients typically see DAVID ALAN JACKSON (MD) under the specialty Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is DAVID ALAN JACKSON (MD)'s primary listing?
We display Montgomery, Ohio because that is what the record indicates for DAVID ALAN JACKSON (MD).
What if Montgomery, Ohio seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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