MR. JACKSON COOPER – Family Nurse Practitioner, NPI 1043056757

MR. JACKSON COOPER is a healthcare provider. based in Jackson, Mississippi. specializing in NURSE PRACTITIONER. They hold a License No. 906765 (MS). The NPI Number for MR. JACKSON COOPER is 1043056757

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
MR. JACKSON COOPER
NPI
1043056757
Phone
(601) 981-9503
Address
971 LAKELAND DR STE 1052
Enumeration Date
2 July 2024
Last Update Date
2 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6019819503
Graduation Year
2024 (2 years ago)
PAC ID
3173060373
Group Practice PAC ID
7517934292
Professional Enrollment ID
I20240806002403
Address ID
MS392164609JA971XXDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

4,566 NURSE PRACTITIONER in MS

Provider Addresses for MR. JACKSON COOPER

  • 971 LAKELAND DR STE 1052

    JACKSON, MS 392164609

    Phone: (601) 981-9503

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 51 Open Payments records for all available years, with a total value of $1,117.

Total Amount is formed as General ($1,117) + Research ($0) + Ownership ($0) = $1,117.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: GENZYME CORPORATION ($307).

Total Amount

$1,117

General + Research + Ownership

Payments

51

Total payment records

General Amount

$1,117

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2024-08-06

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240806002403INurse PractitionerMSTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 39216)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517934292View full group profile
NameSpecialtyState
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMS
Nurse PractitionerMS
-MS
Nurse PractitionerMS
Nurse PractitionerMS
Nurse PractitionerMS
-MS
Pulmonary Disease, Internal MedicineMS
-MS
Nurse PractitionerMS

Reviews

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Frequently asked questions

How do payers reference MR. JACKSON COOPER?
For MR. JACKSON COOPER, use NPI 1043056757 as the unique 10-digit identifier.
Is there an active status for MR. JACKSON COOPER?
For scheduling context, MR. JACKSON COOPER is shown as active in the registry.
What expertise is attributed to MR. JACKSON COOPER?
MR. JACKSON COOPER's specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MR. JACKSON COOPER?
Travel planning: use Jackson, Mississippi as the reference point for MR. JACKSON COOPER, then confirm.
Does MR. JACKSON COOPER accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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