Shawn Jackson, M,D,
Shawn Jackson, M,D, is an Anatomic Pathology & Clinical Pathology Physician in Springfield, MO, registered under NPI 1730258708. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 1000 E PRIMROSE ST STE 550, Springfield, MO 65807. 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 |
|---|---|---|
| 2005005716 | MO | Anatomic Pathology & Clinical Pathology… primary |
| 2005005716 | MO | Dermatopathology (Pathology) Physician |
This provider holds licence 2005005716 issued in MO. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Pathology
- PAC ID
- 0446153514
Enrolled in Medicare 3 times, across 3 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Missouri | I20050519000011 | Practitioner - Pathology |
| Louisiana | I20251230001333 | Practitioner - Pathology |
| Illinois | I20260107002685 | Practitioner - Pathology |
Medicare enrolment is recorded as approved under the provider type Practitioner - Pathology. There are 3 separate enrolment records across 3 states (MO, LA, IL). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Anatomic Pathology & Clinical Pathology covers
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. NUCC Health Care Provider Taxonomy, code 207ZP0102X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician Anatomic Pathology & Clinical Pathology | 2005005716 | MO | primary |
| 207ZD0900X | Dermatopathology (Pathology) Physician Dermatopathology | 2005005716 | MO |
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 | 1730258708 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Nov 6, 2006 |
| Last updated | Jan 2, 2026 |
| Status | Active |
| Sole proprietor | No |
| Credential | M,D, |
| Practice address |
1000 E PRIMROSE ST STE 550 Springfield, MO 65807 (417) 269-4646 |
| Other identifiers |
700100407
· Medicaid (MO) 1101160 · Other (MO) 421539307 · Other (MO) 1559 · Other (MO) 431451388 · Other (MO) 159012 · Other (MO) 705866705 · Medicaid (MO) |
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 | 7 | 3 | 0 | 2 | 5 | 8 | 7 | 0 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 7 | 6 | 0 | 4 | 5 | 7 | 7 | 0 |
Sum = 62 · next multiple of 10 = 70 · check digit = 8 · actual last digit = 8
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.