Michael F Jackson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

106810 Issued in MO

Practice address

12639 Old Tesson Rd Ste 130
Saint Louis, MO 63128-4814

Phone

(636) 386-7222

Fax

(636) 386-7810

NPI assigned

Jan 19, 2006

Last updated

Jan 30, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• South County Anesthesia Associates, LTD.

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1821031659
  Medicare reassignment NPD
• Ambulatory Anesthesia Services of St. Charles, LLC

  • Anesthesiology Physician
  • Saint Peters, MO
  • NPI 1467634097
  Medicare reassignment
• Metro-West Anesthesia Group Inc

  • Anesthesiology Physician
  • Chesterfield, MO
  • NPI 1245427335
  Medicare reassignment
• South County Anesthesia Associates, LTD

  dba PRO Pain

  • Pain Clinic/Center
  • Wentzville, MO
  • NPI 1114290749
  NPD
• Anesthesia Partners, LTD.

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1043270465
  NPD (past)
• Forest Park Anesthesia, Inc

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1962432914
  NPD (past)
• Jefferson Memorial Surgical Partners LLC

  dba Jefferson Memorial Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Festus, MO
  • NPI 1548224207
  NPD (past)
• Specialists in Anesthesia PC

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1689619280

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1538149265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22407",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631260407",
            "telephone_number": "636-386-7222",
            "fax_number": "636-386-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD STE 130",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631284814",
            "telephone_number": "636-386-7222",
            "fax_number": "636-386-7810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10010 Kennerly Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282106",
            "country_code": "US",
            "telephone_number": "636-386-7222 x157",
            "fax_number": "636-386-7810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "106810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "913910147",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda L Jackson
• Luciana (Shawna) Jackson, LCSW
• Malica Nicole Jackson, RN
• Maya Elizabeth Jackson, OTR/L
• Melissa Jackson
• Myoka Carlesha Jackson
• Nicole L Jackson, LPC
• Nicole Lynn Jackson, RN
• Pamela Jackson, D.D.S.
• Pamela Jackson, CRC

• Certified Registered Nurse Anesthetist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.