DR. EDWARD LESLIE JACKSON (M.D.) – Pulmonary Disease Physician, NPI 1174506448
Pulmonary Disease Physician
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Profile Insights
NPPES metrics only — not quality of care.
127 PULMONARY DISEASE in AR
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Provider Addresses for DR. EDWARD LESLIE JACKSON (M.D.)
Fayetteville Post Office, 12, West Dickson Street, Fayetteville, Washington County, Arkansas, 72701, United States
FAYETTEVILLE, AR 727021523
Phone: (479) 521-8200
Fax: (479) 582-7310
Type: Mailing
Fayetteville Diagnostic Clinic, 3344, North Futrall Drive, North Hills Medical Park, Fayetteville, Washington County, Arkansas, 72703, United States
FAYETTEVILLE, AR 727034057
Phone: (479) 521-8200
Fax: (479) 582-7310
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 106 Open Payments records for all available years, with a total value of $1,841.
Total Amount is formed as General ($1,841) + Research ($0) + Ownership ($0) = $1,841.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($567).
Total Amount
$1,841
General + Research + Ownership
Payments
106
Total payment records
General Amount
$1,841
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $567 |
| AstraZeneca Pharmaceuticals LP | $284 |
| GENZYME CORPORATION | $165 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $131 |
| CSL Behring | $100 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2006-06-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060622000312 | I | Pulmonary Disease | AR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 2,000 | 18 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 368 | 288 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 255 | 121 | $0 |
| 94729 | Test to examine how well the lungs exchange gases | 194 | 189 | $0 |
| 94060 | Test to measure expiratory airflow and volume changes before and after medication administration | 193 | 189 | $0 |
Insurance plans in this area (ZIP 72702)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PULMONARY DISEASE | AR | 90670 | Pneumococcal vaccine for injection into muscle | 22 | 22 |
| PULMONARY DISEASE | AR | 94060 | Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration | 226 | 225 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| E N D O C R I N O L O G Y | AR | |
| Internal Medicine | AR | |
| Diagnostic Radiology | AR | |
| - | AR | |
| Family Practice | AR | |
| - | AR | |
| - | AR | |
| Diagnostic Radiology | OK | |
| - | AR | |
| Diagnostic Radiology | AR |
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