Individual provider Active NPI

James W Jackson Jr., MD

  • Pain Medicine (Anesthesiology) Physician
  • Louisville, KY
National Provider Identifier
1063583268
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
41100 Issued in KY
Practice address
120 Executive Park
Louisville, KY 40207
Phone
(502) 855-7200
Fax
(502) 855-7201
NPI assigned
Nov 11, 2006
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 41100 KY Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 01062749A IN
Interventional Pain Medicine Physician 208VP0014X 41100 KY

Addresses

Primary practice location

120 Executive Park
Louisville, KY 40207

Mailing address

PO Box 21890
Belfast, ME 04915-4115
Phone (502) 907-0356

Other practice location 1

4420 Dixie Hwy Ste 107
Louisville, KY 40216-2986
Phone (502) 855-7200

Other practice location 2

935 Chambers Blvd
Bardstown, KY 40004-2575
Phone (270) 506-3300

Other practice location 3

101 Prosperous Pl Ste 300
Lexington, KY 40509-1836
Phone (859) 275-5229

Other practice location 4

530 S Jackson St
Louisville, KY 40202-1675
Phone (502) 852-6901

Other practice location 5

1107 Crown Pointe Dr Ste 107
Elizabethtown, KY 42701-7280
Phone (270) 506-3300

Other practice location 6

3602 Northgate Ct Ste 39
New Albany, IN 47150-6438
Phone (812) 670-5684

Other identifiers 8

IdentifierTypeStateIssuer
002903176OtherUNITED HEALTHCARE PROVIDER ID NUMBER
135386KYIPOtherKYAETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
7100003940MedicaidKY
719905OtherKYWELLCARE OF KY PROVIDER ID
CS1434500725OtherCARESOURCE ID
9121168OtherAETNA PIN
200872860MedicaidIN
000000858929OtherANTHEM PIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address james.jackson.1@16521.direct.athenahealth.com
Direct Messaging Address james.jackson.1@16521.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070727000297 KY Practitioner - Pain ManagementPractitioner - Anesthesiology 7719088277 Reassigns benefits to 1 organization
I20140414001428 IN Practitioner - Pain ManagementPractitioner - Anesthesiology 7719088277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
University of Louisville School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Pain Associates PLLCGroup PAC ID 0941441919, 156 clinicians

Practice addresses (Care Compare)

101 Prosperous PL
Suite 300
Lexington, KY 40509-1836
Phone (859) 275-5229

1107 Crown Pointe Dr
Suite 107
Elizabethtown, KY 42701-7280
Phone (270) 506-3300

120 Executive Park
Louisville, KY 40207-4201

223 Executive Park
Loisville, KY 40207-4202

225 Executive Park
Louisville, KY 40207-4202
Phone (502) 855-7200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.99 of 100Reported as group
Quality
81.97
Promoting interoperability
97
Improvement activities
40
Cost
77.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01062749AINMDPain Medicine (Anesthesiology) Physician
41100KYMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harrison County Chiropractic PC PastSince Dec 13, 2020 Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients
University Anesthesiology Associates PSC Pain Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: james.jackson.1@16521.direct.athenahealth.com
  • Direct secure messaging: james.jackson.1@21632.direct.athenahealth.com

Organizations & group practices 4

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1063583268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21890",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154115",
            "telephone_number": "502-907-0356",
            "fax_number": "502-919-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 EXECUTIVE PARK",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40207",
            "telephone_number": "502-855-7200",
            "fax_number": "502-855-7201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4420 Dixie Hwy Ste 107",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402162986",
            "country_code": "US",
            "telephone_number": "502-855-7200",
            "fax_number": "502-855-7201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "935 Chambers Blvd",
            "address_purpose": "LOCATION",
            "city": "Bardstown",
            "state": "KY",
            "postal_code": "400042575",
            "country_code": "US",
            "telephone_number": "270-506-3300",
            "fax_number": "270-506-2843",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Prosperous Pl Ste 300",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405091836",
            "country_code": "US",
            "telephone_number": "859-275-5229",
            "fax_number": "859-977-2683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "530 S Jackson St",
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            "state": "KY",
            "postal_code": "402021675",
            "country_code": "US",
            "telephone_number": "502-852-6901",
            "fax_number": "502-852-6056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1107 Crown Pointe Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427017280",
            "country_code": "US",
            "telephone_number": "270-506-3300",
            "fax_number": "270-506-2843",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3602 Northgate Ct Ste 39",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471506438",
            "country_code": "US",
            "telephone_number": "812-670-5684",
            "fax_number": "812-941-0814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JAMES",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-11",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "KY",
            "license": "41100",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": "01062749A",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "KY",
            "license": "41100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROVIDER ID NUMBER",
            "identifier": "002903176",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER",
            "identifier": "135386KYIP",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100003940",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF KY PROVIDER ID",
            "identifier": "719905",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE ID",
            "identifier": "CS1434500725",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "9121168",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200872860",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000858929",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.jackson.1@16521.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1107 Crown Pointe Dr Ste 107",
            "city": "Elizabethtown",
            "state": "KY",
            "country_code": "US",
            "postal_code": "427017280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.jackson.1@16521.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "120 Executive Park",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.