IndividualActive
Heather Jackson, D.O.
NPI 1104034008 · Family Medicine Physician · Beavercreek, OH
Provider details
- NPI number
- 1104034008
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- No
- License
- 34010401 (OH)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES 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
2322 Lakeview Dr
Beavercreek, OH 45431-2772
Phone: (937) 426-0106
Fax: (937) 426-7153
Street-level locationGet directions
Mailing address
4700 Smith Rd
Cincinnati, OH 45212-2787
Registry dates
- Enumerated
- 2007-05-21
- Last updated
- 2014-02-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.