NPIMap

Individual provider Active NPI

John Clarke Jackson, M.D.

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1992065445
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
56686 Issued in TN
Practice address
3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
May 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 56686 TN Primary
Diagnostic Radiology Physician 2085R0202X E-10117 AR
Diagnostic Radiology Physician 2085R0202X 22996 MS

Addresses

Primary practice location

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915

Mailing address

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (952) 595-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IA, IL, FL, SC5 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20180517000418 TN Practitioner - Diagnostic Radiology 6800179821 Reassigns benefits to 7 organizations
I20180817001677 IA Practitioner - Diagnostic Radiology 6800179821 Reassigns benefits to 1 organization
I20181231000155 IL Practitioner - Diagnostic Radiology 6800179821 Reassigns benefits to 1 organization
I20230924000113 FL Practitioner - Diagnostic Radiology 6800179821 Reassigns benefits to 2 organizations
I20260316000234 SC Practitioner - Diagnostic Radiology 6800179821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Tennessee, HSC, College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Burlington County P a 153 clinicians
Singleton Associates PA 814 clinicians
Fred Smeltzer MD and Associates Inc 95 clinicians
Virtual Radiologic Professionals LLC 392 clinicians
Englewood Radiologic Group P a 131 clinicians

Practice addresses (Care Compare)

Nashville, TN 37221
Phone (856) 229-0696

101 Iroquois CT
Nashville, TN 37205-3809
Phone (281) 870-4592

1325 Snell Isle Blvd NE
Unit 305
St. Petersburg, FL 33704-2411
Phone (315) 663-6903

320 Creekshire Dr
Signal Mountain, TN 37377-2086
Phone (423) 886-3516

3605 Belvidere CT
Murfreesboro, TN 37127-7163
Phone (952) 595-1100

4175 Ventana Blvd
Rockledge, FL 32955-5348
Phone (952) 595-1100

5040 Murray LN
Brentwood, TN 37027-5801
Phone (952) 595-1100

7516 Rigby CT
Lakewood Ranch, FL 34202-2453
Phone (952) 595-1100

Hospital & facility affiliations

  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186
  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071
  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045
  • Medical Center Hospital Hospital, Odessa, TX, CCN 450132

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22996MSMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Burlington County P a Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Spencer Municipal Hospital CurrentSince Oct 1, 2021 Accepting new patients
South Jersey Radiology Associates P a Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Midwest Medical Center CurrentSince Dec 5, 2018 Accepting new patients
Spencer Municipal Hospital CurrentSince Oct 1, 2021 Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Fred Smeltzer MD & Associates Inc Diagnostic Radiology CurrentSince Sep 1, 2022 Accepting new patients
Specialists in Medical Imaging, SC Diagnostic Radiology CurrentSince Aug 13, 2025 Accepting new patients
Englewood Radiologic Group P a Diagnostic Radiology CurrentSince Sep 18, 2025 Accepting new patients
Crawford Hospital District Current Accepting new patients
Virtual Radiologic Professionals, LLC Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Midwest Medical Center CurrentSince Dec 5, 2018 Accepting new patients

Locations

3201 1st St
Emmetsburg, IA 50536
Phone (712) 852-5500

2004 Okoboji Ave
Milford, IA 51351
Phone (712) 338-2461

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

1200 1st Ave E
Ste C
Spencer, IA 51301
Phone (712) 262-7511

1 Medical Center Dr
Galena, IL 61036
Phone (815) 776-7381

11995 Singletree Ln
Ste 500
Eden Prairie, MN 55344
Phone (952) 595-1143

3600 Minnesota Dr
Ste 800
Minneapolis, MN 55435
Phone (612) 595-1100

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 10

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": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1992065445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOHN",
        "middle_name": "CLARKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "56686",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E-10117",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "22996",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.