J Carvel Jackson, D.O.

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

2543 Issued in AZ

Practice address

303 N Centennial Way
Mesa, AZ 85201-6733

Phone

(480) 649-3111

Fax

(480) 649-3113

NPI assigned

Apr 3, 2006

Last updated

Feb 2, 2023By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 30, 2025 through Nov 30, 2027

Specialty

Physical Medicine and Rehabilitation

Education

College of Osteo Med of the Pacific at Pomona, 1988

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

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.

• Addiction Navigators PLLC

  • Addiction Medicine (Internal Medicine) Physician
  • Mesa, AZ
  • NPI 1467195347
  NPD Authorized official
• Orthopedic Performance Therapy LLC

  • Physical Therapy Clinic/Center
  • Mesa, AZ
  • NPI 1275483679
  NPD (past)

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1942262399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N CENTENNIAL WAY",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016733",
            "telephone_number": "480-649-3111",
            "fax_number": "480-649-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CENTENNIAL WAY",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016733",
            "telephone_number": "480-649-3111",
            "fax_number": "480-649-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "J",
        "middle_name": "CARVEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "AZ",
            "license": "2543",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "2543",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111328",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alain Jeanine Jackson
• Casiel Dominique Jackson, LAC
• Crista Jackson
• Danielle Jackson
• Erika Jackson, MA
• J Ryan Jackson, DO
• Janel Jackson, LAC
• Jennifer R Jackson, LPC
• Jillian Jackson, PA
• Joshua Jackson

• Addiction Medicine (Internal Medicine) Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Addiction Medicine (Internal Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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; Opt Out Affidavits.
• 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.