Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackson D Gannon, PA-C

Individual provider Surgical Physician Assistant · NPI 1790357358

Jackson D Gannon, PA-C is a Physician Assistant in Omaha, Nebraska. Qualified in 2021, 5 years ago. Practices with Unmc Physicians, a 1,484-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Nebraska.

Years since qualifying
5
Licensed in
NE
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

8200 Dodge St
Omaha, NE 68114-4113
Phone: (402) 955-8600
Fax: (402) 955-5905
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 2632 (NE)

Record details

NPI number1790357358
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 13, 2021
Last updated in NPPESJuly 13, 2021
Certification dateJuly 13, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Unmc Physicians — 1484 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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