Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Carl-Christian Andrew Jackson, MD

Pediatric Surgery Physician in Providence, RI · enumerated 2007.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1235355173

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Registry record

Entity type Individual (Type 1)

Name Carl-Christian Andrew Jackson

Credential MD

Sex Male

Practice address 2 Dudley St Ste 190, Providence, RI, 02905

Phone (401) 228-0623

Fax (401) 868-2319

Enumeration date Apr 18, 2007

Last updated in NPPES Nov 26, 2025

Taxonomy & licenses

208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Allopathic & Osteopathic Physicians · License A88272 (CA) Secondary

2086S0120X Pediatric Surgery Physician Allopathic & Osteopathic Physicians · License MD18790 (RI) Primary

2086S0120X Pediatric Surgery Physician Allopathic & Osteopathic Physicians · License 231415 (MA) Secondary

208600000X Surgery Physician Allopathic & Osteopathic Physicians · License 036-106668 (IL) Secondary

MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier	Type	State	Issuer
00A882720	Medicaid	CA	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Is this the official NPI registry?

No. NPI Portal is a private site built on public CMS NPPES data. The official registry is npiregistry.cms.hhs.gov, operated by CMS.

What specialty is Carl-Christian Jackson?

Carl-Christian Jackson is registered in NPPES with the primary taxonomy of Pediatric Surgery Physician. The taxonomy code describes the provider's classification and area of specialization for claims and credentialing.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-11-26.