Shawn Barrett Jackson, M,D,

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

2005005716 Issued in MO

Practice address

1000 E Primrose St Ste 550
Springfield, MO 65807-5180

Phone

(417) 269-4646

NPI assigned

Nov 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MO, LA, IL3 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 3

Specialty

Pathology

Education

University of Colorado School of Medicine, Aurora, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pathology Services of Springfield PCGroup PAC ID 2062308133, 9 clinicians

Dermatology and Mohs Surgery Skin Cancer CenterGroup PAC ID 8527447945, 8 clinicians

Cenla DermatologyGroup PAC ID 0446679161, 6 clinicians

Dermatology and Skin Cancer CenterGroup PAC ID 2668821919, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cox Medical Centers Hospital, Springfield, MO, CCN 260040
• Cox Medical Center Branson Hospital, Branson, MO, CCN 260094
• Cox Monett Hospital Hospital, Monett, MO, CCN 261329
• Cox Barton County Hospital Hospital, Lamar, MO, CCN 261325

Merit-based Incentive Payment System (MIPS)

Final score

90 of 100Reported as group

Quality

80

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Dermatology and Mohs Surgery Skin Cancer Center

  • Dermatology Physician
  • Branson, MO
  • NPI 1124763479
  Medicare reassignment Care Compare group NPD
• Pathology Services of Springfield, P.C.

  • Clinical Medical Laboratory
  • Springfield, MO
  • NPI 1801935879
  Medicare reassignment Care Compare group NPD
• Cenla Dermatology

  • Dermatology Physician
  • Alexandria, LA
  • NPI 1851919005
  Medicare reassignment Care Compare group NPD
• Dermatology and Skin Cancer Center

  • Dermatology Physician
  • Bloomington, IL
  • NPI 1093596652
  Medicare reassignment Care Compare group NPD
• Citizens Memorial Hospital District

  • Emergency Medicine Physician
  • Bolivar, MO
  • NPI 1558548818
  Medicare reassignment NPD
• Citizens Memorial Hospital District

  • Community/Retail Pharmacy
  • Buffalo, MO
  • NPI 1427480995
  NPD
• The Vein Specialists, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bloomington, IL
  • NPI 1861703100
  NPD

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

• Cox Barton County Hospital

  • Critical Access Hospital
  • Lamar, MO
  • NPI 1922514629
  Care Compare affiliation
• Cox-Monett Hospital, Inc.

  • Critical Access Hospital
  • Monett, MO
  • NPI 1194757500
  Care Compare affiliation
• Lester E Cox Medical Centers

  • General Acute Care Hospital
  • Springfield, MO
  • NPI 1093740128
  Care Compare affiliation
• Lester E Cox Medical Centers

  • Land Ambulance
  • Springfield, MO
  • NPI 1114044823

  Hospital

  Care Compare affiliation
• Lester E. Cox Medical Centers

  • Air Ambulance
  • Springfield, MO
  • NPI 1578680286

  Hospital

  Care Compare affiliation
• Skaggs Community Hospital Association

  • General Acute Care Hospital
  • Branson, MO
  • NPI 1760443980
  Care Compare affiliation

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1730258708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E PRIMROSE ST STE 550",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075180",
            "telephone_number": "417-269-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PRIMROSE ST STE 550",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075180",
            "telephone_number": "417-269-4646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1230 E Kingsley St Ste A&b",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658047211",
            "country_code": "US",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1587 N Bolton Ave Ste 1300",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713034255",
            "country_code": "US",
            "telephone_number": "318-933-3376",
            "fax_number": "318-933-3377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3302 Gerig Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617046343",
            "country_code": "US",
            "telephone_number": "309-533-7070",
            "fax_number": "855-710-6552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SHAWN",
        "middle_name": "BARRETT",
        "credential": "M,D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2005005716",
            "primary": true
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "MO",
            "license": "2005005716",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "700100407",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1101160",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED TAX ID-TRI-LAKES PATH",
            "identifier": "421539307",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD-PATHO",
            "identifier": "1559",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED TAX ID-PATHOLOGY SERV",
            "identifier": "431451388",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD-TRI-L",
            "identifier": "159012",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "705866705",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Jackson, LMT
• Delilah Yvette Jackson
• Michael Wayne Jackson, D.C.
• Rachael M Jackson, LMSW
• Sarah Beth Jackson, DDS
• Tierra Leanne Jackson, TATTOO LICENSE
• Wendy R Jackson, LCSW
• Jacob'S Home Care LLC
• Blake Jacobs, MD
• Courtney M. Jacobson, LCSW

• Anatomic Pathology & Clinical Pathology Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Anatomic Pathology & Clinical Pathology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.