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

Kenneth Jason Jackson, MD

Individual provider Family Medicine Physician · NPI 1174083810

Kenneth Jason Jackson, MD is a Family Practice in Lebanon, New Hampshire. Graduated from Howard University College of Medicine in 2019, 7 years ago. Practices with Medical Affiliates of Cape Cod Inc, a 235-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Hampshire.

Years since qualifying
7
Trained at
Howard University College of Medicine
Licensed in
NH
In the registry since
2019
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

18 Old Etna Rd
Lebanon, NH 03766-1937
Phone: (603) 650-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 22456 (NH)

Record details

NPI number1174083810
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 20, 2019
Last updated in NPPESAugust 19, 2022
Certification dateAugust 17, 2022

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolHOWARD UNIVERSITY COLLEGE OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice Medical Affiliates Of Cape Cod Inc — 235 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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