Jackson Center, PA
NPI 1417013707ActiveOrganization· Dermatology· Naples, FL
Dermatology in Naples, Florida, registered in NPPES in December 2006. The authorized official on file is Jon Ryan Jackson, MD, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1417013707 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 29, 2006 |
| Last updated in NPPES | Feb 17, 2023 |
| Certified by provider | Feb 17, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Plastic Surgery | 208200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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