Individual provider Active NPI

Kasey Jackson, MD

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1053730416
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME176093 Issued in FL
Practice address
1561 S Alafaya TRL Ste 400
Orlando, FL 32828-8956
Phone
(407) 249-1234
Fax
(407) 249-1755
NPI assigned
Apr 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 61971 TN
Pediatric Hematology & Oncology Physician 2080P0207X 61971 TN
Pediatric Hematology & Oncology Physician 2080P0207X R3536 TX
Pediatrics Physician 208000000X ME176093 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1561 S Alafaya TRL Ste 400
Orlando, FL 32828-8956

Mailing address

900 S Pine Island Rd Ste 800
Plantation, FL 33324-3923
Phone (407) 249-1234

Other practice location 1

1500 Cooper St
Fort Worth, TX 76104-2710
Phone (682) 885-4007

Other practice location 2

6701 Fannin St
Houston, TX 77030-2608
Phone (832) 824-1000

Other practice location 3

3601 The Vanderbilt Clinic
Nashville, TN 37232-2608
Phone (615) 322-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231114002374 TX Practitioner - Pediatric MedicinePractitioner - Hematology/Oncology 4385945344 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network Pediatrics CurrentSince Oct 23, 2023 Accepting new patients
Cook Children'S Physician Network Pediatrics CurrentSince Oct 23, 2023 Accepting new patients
Saltzman, Tanis, Pittel, Levin and Jacobson, LLC Pediatrics PastSince Mar 27, 2022 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics Past Accepting new patients
The Nemours Foundation Past Accepting new patients

Locations

7000 Calmont Ave
Ste 150
Fort Worth, TX 76116
Phone (682) 885-6163

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

1500 Cooper St
Ft Worth, TX 76104
Phone (682) 885-2500

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: kjackson155316@direct.nemours.org
  • Direct secure messaging: kjackson443973@direct.vumc.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1053730416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD STE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243923",
            "telephone_number": "407-249-1234",
            "fax_number": "407-249-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 S ALAFAYA TRL STE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288956",
            "telephone_number": "407-249-1234",
            "fax_number": "407-249-1755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Cooper St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761042710",
            "country_code": "US",
            "telephone_number": "682-885-4007",
            "fax_number": "682-885-4004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6701 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302608",
            "country_code": "US",
            "telephone_number": "832-824-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 The Vanderbilt Clinic",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372322608",
            "country_code": "US",
            "telephone_number": "615-322-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KASEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "61971",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TN",
            "license": "61971",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TX",
            "license": "R3536",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME176093",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.