EDWIN J. JACKSON, JR. DO – NPI #1972827335
Internal Medicine

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Health Care Provider Taxonomy Code for Internal Medicine

EDWIN JACKSON, JR. is a physician located in DANVILLE, IN. NPPES has assigned the NPI number 1972827335 to EDWIN JACKSON, JR. on March 15, 2010. It is a Type-1 NPI, indicating this NPI number is associated with an individual. According to the NPI data, there are 2 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RC0200X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Critical Care Medicine

The NPI profile was last updated on Mar 11, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EDWIN JACKSON, JR. below.

NPI Profile for
EDWIN J. JACKSON, JR.

NPI Number
1972827335
Enumeration Date

(more than 16 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
EDWIN J. JACKSON, JR.
Credentials
DO
Primary location
112 HOSPITAL LN STE 303
DANVILLE, IN 46122
Phone: (317) 718-4000 Fax: (317) 718-4005
2 Other location(s):
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone: (888) 484-3258
720 Eskenazi Ave
Indianapolis, IN 46202-5187
Phone: (317) 808-2224
Fax: (317) 880-0000
Mailing address
250 N SHADELAND AVE
INDIANAPOLIS, IN 46219-4959
Phone: Fax:
Sole Proprietor
No
Updated
Certification Date
Mar 11, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for EDWIN JACKSON, JR.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherANTHEM PTANIN000001612224
medicaidOH0093373
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RC0200X
- Internal Medicine / Critical Care Medicine (Primary)		 IN 02005444A
207RP1001X
- Internal Medicine / Pulmonary Disease		 OH 34.010939
207R00000X
- Internal Medicine		 IN 02005444A

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

View All Endpoint(s)
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
112 HOSPITAL LN STE 303,
DANVILLE, IN 77025-1669
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
1701 N SENATE BLVD,
INDIANAPOLIS, IN 77025-1669
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
720 ESKENAZI AVE,
INDIANAPOLIS, IN 77025-1669

Additional Information

Education
OHIO UNIVERSITY, COLLEGE OF OSTEOPATHIC MEDICINE - Graduated 2010
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
EDWIN JACKSON, JR. is affiliated with the following medical group(s):
  • HOSPITAL
    • ESKENAZI HEALTH
      720 ESKENAZI AVENUE
      INDIANAPOLIS, IN 46202
    • HENDRICKS REGIONAL HEALTH
      1000 E MAIN ST
      DANVILLE, IN 46122
    • INDIANA UNIVERSITY HEALTH
      1701 N SENATE BLVD
      INDIANAPOLIS, IN 46202

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.