NPIMap

Individual provider Active NPI

Cassandra Ray Jackson, MD

  • Psychiatry Physician
  • Sioux Falls, SD
National Provider Identifier
1053998781
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0615 Issued in SD
Practice address
4400 W 69TH St Ste 500
Sioux Falls, SD 57108-8171
Phone
(605) 322-5700
NPI assigned
Mar 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0615 SD Primary
Psychiatry Physician 2084P0800X 72875 MN
Student in an Organized Health Care Education/Training Program 390200000X SD

Addresses

Primary practice location

4400 W 69TH St Ste 500
Sioux Falls, SD 57108-8171

Mailing address

4400 W 69TH St Ste 500
Sioux Falls, SD 57108-8171
Phone (605) 988-4781

Other practice location 1

301 Becker Ave SW
Willmar, MN 56201-3302
Phone (320) 235-4543

Other practice location 2

1406 6th Ave N
Saint Cloud, MN 56303-1900
Phone (320) 240-2836

Other practice location 3

1400 W 22nd St
Sioux Falls, SD 57105-1554
Phone (605) 322-5737

Other practice location 4

300 S Bruce St
Marshall, MN 56258-1934
Phone (507) 537-9318

Other names 1

  • Cassie Jackson Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cjackson662451@direct.centracare.com Direct
Direct Messaging Address cjackson662451@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230103000017 MN Practitioner - Psychiatry 7517369309 Reassigns benefits to 5 organizations
I20231207002949 SD Practitioner - Psychiatry 7517369309

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians
Carris Health LLCGroup PAC ID 7012274228, 40 clinicians

Practice addresses (Care Compare)

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

301 Becker Ave SW
Willmar, MN 56201-3302
Phone (320) 235-4543

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Southwest LLC CurrentSince Dec 1, 2022 Accepting new patients
Centracare Health System-NR LLC CurrentSince Apr 1, 2025 Accepting new patients
Carris Health LLC Psychiatry CurrentSince Dec 1, 2022 Accepting new patients
St. Cloud Hospital CurrentSince Dec 1, 2022 Accepting new patients
Avera McKennan Psychiatry CurrentSince Oct 14, 2023 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Dec 1, 2022 Accepting new patients
Carris Health LLC CurrentSince Dec 1, 2022 Accepting new patients
Avera McKennan CurrentSince Oct 14, 2023 Accepting new patients
St. Cloud Hospital CurrentSince Dec 1, 2022 Accepting new patients
Avera McKennan Current Accepting new patients
St. Cloud Hospital Current Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients

Locations

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

1604 1st St S
Willmar, MN 56201
Phone (320) 231-5039

4400 W 69th St
Ste 1500
Sioux Falls, SD 57108
Phone (605) 322-5700

4400 W 69th St
Sioux Falls, SD 57108
Phone (605) 322-4005

4400 W 69th St
Ste 500
Sioux Falls, SD 57108
Phone (605) 322-5700

Organizations & group practices 12

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1616803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1053998781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W 69TH ST STE 500",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088171",
            "telephone_number": "605-988-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 69TH ST STE 500",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088171",
            "telephone_number": "605-322-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Becker Ave SW",
            "address_purpose": "LOCATION",
            "city": "Willmar",
            "state": "MN",
            "postal_code": "562013302",
            "country_code": "US",
            "telephone_number": "320-235-4543",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1406 6th Ave N",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563031900",
            "country_code": "US",
            "telephone_number": "320-240-2836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 W 22nd St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051554",
            "country_code": "US",
            "telephone_number": "605-322-5737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 S Bruce St",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "MN",
            "postal_code": "562581934",
            "country_code": "US",
            "telephone_number": "507-537-9318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CASSANDRA",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-27",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "0615",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "72875",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjackson662451@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cjackson662451@direct.centracare.com",
            "address_1": "1406 6th Ave N",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563031900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjackson662451@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cjackson662451@direct.centracare.com",
            "address_1": "301 Becker Ave SW",
            "city": "Willmar",
            "state": "MN",
            "country_code": "US",
            "postal_code": "562013302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CASSIE",
            "last_name": "JACKSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.