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Travis Jackson, MD
NPI 1093657439 · Dermatology Physician · Saint Louis, MO
Travis Jackson, MD is a Dermatology Physician provider in Saint Louis, MO (NPI 1093657439).
Provider details
- NPI number
- 1093657439
- Entity type
- Individual
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 2026021643 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
621 S New Ballas Rd Ste 3019b
Saint Louis, MO 63141-8267
Phone: (314) 509-5305
Fax: (314) 251-4454
Street-level locationGet directions
Mailing address
621 S New Ballas Rd Ste 3019b
Saint Louis, MO 63141-8267
Registry dates
- Enumerated
- 2026-04-06
- Last updated
- 2026-05-27
- Certified
- 2026-05-27
Frequently asked questions
- What is Travis Jackson's NPI number?
- Travis Jackson's National Provider Identifier (NPI) is 1093657439, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Travis Jackson's specialty?
- Travis Jackson is listed in the NPPES registry with a primary specialty of Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Travis Jackson located?
- Travis Jackson's practice location on file with NPPES is 621 S New Ballas Rd Ste 3019b, Saint Louis, MO 63141-8267.
- What is Travis Jackson's phone number?
- The practice phone number listed in the NPPES registry for Travis Jackson is (314) 509-5305.
- Is Travis Jackson's NPI active?
- Yes — Travis Jackson's NPI (1093657439) is active in the NPPES registry as of the last update on 2026-05-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.