JOHN RICHARD JACKSON (M.D.) – Family Medicine Physician, NPI 1457350902
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
8,705 FAMILY PRACTICE in TX
Provider Addresses for JOHN RICHARD JACKSON (M.D.)
Cumming Highway, Canton, Cherokee County, Georgia, 30115, United States
SUITE 300
CANTON, GA 301152914
Phone: (770) 720-2113
Fax: (770) 704-7365
Type: Mailing
1290 WONDER WORLD DR STE 1100
SAN MARCOS, TX 786667969
Phone: (512) 393-3325
Fax: (512) 393-3328
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $36.
Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.
Last reported payment date: 2024-09-17 • Largest payer in this snapshot: Abbott Laboratories ($20).
Total Amount
$36
General + Research + Ownership
Payments
2
Total payment records
General Amount
$36
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $20 |
| Lilly USA, LLC | $16 |
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: 2021-09-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20051128000141 | I | Emergency Medicine | GA | TBD |
| I20210909002396 | I | Family Practice | TX | 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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 105 | 65 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 97 | 59 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 29 | 25 | $0 |
| G0008 | Administration of influenza virus vaccine | 12 | 12 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 12 | 12 | $0 |
Insurance plans in this area (ZIP 30115)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | ND | |
| Nurse Practitioner | TX | |
| - | TX | |
| - | TX | |
| Physician Assistant | TX | |
| Nurse Practitioner | TX | |
| Family Practice | TX | |
| Physician Assistant | TX | |
| - | TX | |
| - | TX |
Reviews
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