Individual provider Active NPI

Kristen Jackson, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Danbury, CT
National Provider Identifier
1255727558
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
79731 Issued in CT
Practice address
25 Germantown Rd
Danbury, CT 06810-5036
Phone
(203) 794-5620
NPI assigned
Apr 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 79731 CT Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X S5935 TX

Addresses

Primary practice location

25 Germantown Rd
Danbury, CT 06810-5036

Mailing address

25 Germantown Rd
Danbury, CT 06810-5036
Phone (203) 794-5620

Other practice location 1

3417 Gaston Ave Ste 980
Dallas, TX 75246-2022
Phone (469) 800-8020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CT2 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
I20201026000749 TX Practitioner - Endocrinology 9739408352 Reassigns benefits to 1 organization
I20250128002569 CT Practitioner - Endocrinology 9739408352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Nebraska College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

25 Germantown Rd
Danbury, CT 06810-5036
Phone (203) 794-5620

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S5935TXMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Sep 28, 2020 Accepting new patients
Nuvance Health Medical Practice CT, Inc. Endocrinology, Diabetes & Metabolism CurrentSince Feb 17, 2025 Accepting new patients
Healthtexas Provider Network Endocrinology, Diabetes & Metabolism CurrentSince Sep 28, 2020 Accepting new patients

Locations

25 Germantown Rd
Danbury, CT 06810
Phone (203) 794-5620

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3417 Gaston Ave
Ste 980
Dallas, TX 75246
Phone (469) 800-8020

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

Organizations & group practices 3

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 2

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1255727558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 GERMANTOWN RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105036",
            "telephone_number": "203-794-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 GERMANTOWN RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105036",
            "telephone_number": "203-794-5620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3417 Gaston Ave Ste 980",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752462022",
            "country_code": "US",
            "telephone_number": "469-800-8020",
            "fax_number": "469-800-8030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "79731",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "S5935",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.