Carl-christian Jackson, MD
Carl-christian Jackson, MD is a Pediatric Surgery Physician in Providence, RI, registered under NPI 1235355173. This provider registers 3 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 2 DUDLEY ST STE 190, Providence, RI 02905. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| MD18790 | RI | Pediatric Surgery Physician primary |
| A88272 | CA | Thoracic Surgery (Cardiothoracic Vascular… |
| 231415 | MA | Pediatric Surgery Physician |
| 036-106668 | IL | Surgery Physician |
Licences are recorded in 4 states: RI, CA, MA, IL. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Pediatric Medicine
- PAC ID
- 2365403367
Medicare enrolment is recorded as approved under the provider type Practitioner - Pediatric Medicine. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 4 states
This provider holds licences in 4 states: California, Illinois, Massachusetts and Rhode Island. The practice address on file is in Providence, RI, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- MD18790
- Specialty
- Pediatric Surgery Physician
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Pediatric Surgery covers
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. NUCC Health Care Provider Taxonomy, code 2086S0120X
All registered taxonomy codes
This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2086S0120X | Pediatric Surgery Physician Pediatric Surgery | MD18790 | RI | primary |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | A88272 | CA | |
| 2086S0120X | Pediatric Surgery Physician Pediatric Surgery | 231415 | MA | |
| 208600000X | Surgery Physician | 036-106668 | IL |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1235355173 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Apr 18, 2007 |
| Last updated | Nov 26, 2025 |
| Status | Active |
| Sole proprietor | No |
| Credential | MD |
| Practice address |
2 DUDLEY ST STE 190 Providence, RI 02905 (401) 228-0623 Fax (401) 868-2319 |
| Mailing address |
15 LASALLE SQUARE Providence, RI 02903 |
| Other identifiers |
00A882720
(CA) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 2 | 3 | 5 | 3 | 5 | 5 | 1 | 7 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 2 | 6 | 5 | 6 | 5 | 1 | 1 | 5 |
Sum = 57 · next multiple of 10 = 60 · check digit = 3 · actual last digit = 3
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.