TRAVIS HAROLD JACKSON MD NPI 1043256126

NPI Information

  • NPI: 1043256126
  • Provider Name: TRAVIS HAROLD JACKSON, MD
  • Classification: Psychiatry & Neurology - 2084N0400X
  • Specialization: Neurology
  • Entity Type: Individual
  • Address: 145 KIMEL PARK DR
    SUITE 100
    WINSTON-SALEM, NC
    ZIP 27103
  • Phone: (336) 768-6347

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NPI Details

Travis Harold Jackson, MD is a neurology psychiatry neurology in Winston-salem, NC. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Travis Harold Jackson, MD NPI is 1043256126. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

145 KIMEL PARK DR
SUITE 100
WINSTON-SALEM, NC
ZIP 27103-983
Phone: (336) 768-6347
Fax: (336) 760-9393

The enumeration date for this NPI number is 6/20/2006 and was last updated on 3/4/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0400XPsychiatry & NeurologyNeurology0000-20148NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18945571MEDICAIDNORTH CAROLINA
2P00288396OTHERNORTH CAROLINARAILROAD MEDICARE
3C84690MEDICARE UPINNORTH CAROLINA
4207533KMEDICARE PINNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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