Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Tedroy Mevrick Jackson, MD

Individual provider Internal Medicine Physician · NPI 1356091490

Dr. Tedroy Mevrick Jackson, MD is an Internal Medicine in Cincinnati, Ohio. Qualified in 2021, 5 years ago. Practices with South Sound Inpatient Physicians PLLC, a 427-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
5
Licensed in
WA
In the registry since
2022
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2123 Auburn Ave Ste 235
Cincinnati, OH 45219-2906
Phone: (513) 585-3238
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD61645378 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Hospitalist Physician Taxonomy 208M00000X · Licence MD.MD.61645378 (WA)

Record details

NPI number1356091490
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 23, 2022
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice South Sound Inpatient Physicians Pllc — 427 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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