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Active NPI 1093657439 Individual Practitioner Male Practitioner

Dr. Travis Wiley Jackson , MD

Dermatology • Saint Louis, MO

Professional Overview & Biography Verified Profile Summary

Dr. Travis Jackson, MD is a registered healthcare professional specializing in Dermatology in Saint Louis, MO. Practice services are available at 621 S NEW BALLAS RD STE 3019B under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

621 S New Ballas Rd Ste 3019b

Saint Louis, MO 631418267

Telephone 3145095305
Fax 3142514454

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Saint Louis, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.1 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
103 Specialists

Practicing in Saint Louis, MO (287 Statewide)

Telehealth Adoption Rate
3.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-05-27
Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License MO 2026021643

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003600685

Doctor of Medicine (M.D.)

Dr. Anas Hasic , MD

Internal Medicine

NPI 1013850718

Doctor of Medicine (M.D.)

Sahas Reddy Jitta

Internal Medicine

NPI 1023796513
Dr. Zachary Tapia , MD

Internal Medicine

NPI 1073366357

Doctor of Medicine (M.D.)

Dr. John Davis , DO

Internal Medicine

NPI 1083408736

Doctor of Osteopathic Medicine (D.O.)

Dr. Fulei Peng , DO

Internal Medicine

NPI 1093382376

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 27, 2026

Dermatology (License #2026021643 in MO)

NPI Profile Active April 06, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location April 06, 2026

Registered at 621 S NEW BALLAS RD STE 3019B, SAINT LOUIS, MO 631418267 (Tel: 3145095305)

📍
Updated Business Mailing Address April 06, 2026

Registered at 621 S NEW BALLAS RD STE 3019B, SAINT LOUIS, MO 631418267 (Tel: 3145095305)

👤
Provider Name / Credentials Updated April 06, 2026

Recorded as TRAVIS JACKSON, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2026

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 06, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1093657439
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 06, 2026
Last Update: May 27, 2026
Sole Proprietor: Yes

Mailing Address

621 S New Ballas Rd Ste 3019b

Saint Louis, MO 631418267

Phone: 3145095305

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.