Individual provider Active NPI

Gayla Estelle Jackson, MD

  • Internal Medicine Physician
  • Florissant, MO
National Provider Identifier
1184852592
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2012019250 Issued in MO
Practice address
1225 Graham Rd Ste C-1350
Florissant, MO 63031-8022
Phone
(314) 953-6690
NPI assigned
Jun 24, 2009
Last updated
Sep 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2012019250 MO Primary

Addresses

Primary practice location

1225 Graham Rd Ste C-1350
Florissant, MO 63031-8022

Mailing address

11155 Dunn Rd Ste 1350C
Saint Louis, MO 63136-6150
Phone (314) 953-6690

Other practice location 1

11155 Dunn Rd Ste 1350C
Saint Louis, MO 63136-6150
Phone (314) 953-6690

Other practice location 2

11155 Dunn Rd Ste 109N
Saint Louis, MO 63136-6148
Phone (314) 953-6968

Other names 1

  • Gayla Guess Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20120731000732 MO Practitioner - Internal Medicine 3173789419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

1225 Graham Rd
Suite 1220B
Florissant, MO 63031-8012
Phone (314) 953-8250

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Physician Groups LC CurrentSince Oct 1, 2019 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Mercy Clinic East Communities Internal Medicine Past Accepting new patients

Locations

1225 Graham Rd
Ste C-1350
Florissant, MO 63031
Phone (314) 953-6690

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

11155 Dunn Rd
Ste 109N
Saint Louis, MO 63136
Phone (314) 837-3784

Interoperability endpoints

  • Direct secure messaging: gjackson1020134@direct.carenet.org
  • Direct secure messaging: gjackson281405@directc.mercy.net

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 4

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1184852592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11155 DUNN RD STE 1350C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366150",
            "telephone_number": "314-953-6690",
            "fax_number": "314-953-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 GRAHAM RD STE C-1350",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318022",
            "telephone_number": "314-953-6690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11155 Dunn Rd Ste 1350C",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631366150",
            "country_code": "US",
            "telephone_number": "314-953-6690",
            "fax_number": "314-953-6960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11155 Dunn Rd Ste 109N",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631366148",
            "country_code": "US",
            "telephone_number": "314-953-6968",
            "fax_number": "314-953-6960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GAYLA",
        "middle_name": "ESTELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2012019250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11155 Dunn Rd Ste 109N",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GAYLA",
            "last_name": "GUESS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Florissant, MO

Sources for this page

Verify at the official NPI Registry.