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

Randolph Thomas Jackson, MD

Individual provider Ophthalmology Physician · NPI 1457310518

Randolph Thomas Jackson, MD is an Ophthalmology in Kansas City, Kansas. Graduated from Medical College of Georgia School of Medicine in 2000, 26 years ago. Practices with Eye Care LLC, a 50-clinician group and accepts Medicare assignment. Licensed in Kansas, Minnesota, Missouri and Montana.

Years since qualifying
26
Trained at
Medical College of Georgia School of Medicine
Licensed in
KS, MN, MO, MT
In the registry since
2006
Specialties on file
4
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

11010 Haskell Ave
Kansas City, KS 66109-8500
Phone: (816) 478-1230
Fax: (816) 350-4166
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence 31896 (KS)
Ophthalmology Physician Taxonomy 207W00000X · Licence 46566 (MN)
Ophthalmology Physician Taxonomy 207W00000X · Licence 10506 (MT)
Ophthalmology Physician Taxonomy 207W00000X · Licence 2006012805 (MO)

Record details

NPI number1457310518
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 18, 2006
Last updated in NPPESMay 7, 2009
Mailing address4801 S Cliff Ave, Suite 100, Independence, MO 64055-7015

Medicare enrollment

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

Medicare specialtyOPHTHALMOLOGY
Medical schoolMEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated 2000 (26 years in practice)
Group practice Eye Care Llc — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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