JACKSON TEER (DO) – Family Medicine Physician, NPI 1861124331

JACKSON TEER (DO) is a healthcare provider. based in Tupelo, Mississippi. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 6036 (TN). The NPI Number for JACKSON TEER (DO) is 1861124331

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
JACKSON TEER (DO)
NPI
1861124331
Phone
(662) 377-2189
Address
1665 S GREEN ST
Enumeration Date
24 June 2022
Last Update Date
1 July 2025

Doctor Profile

Medical School Name
LINCOLN MEM UNIV, DEBUSK COL OF OSTEOPATHIC MED
Secondary Phone
7316861505
Graduation Year
2022 (4 years ago)
PAC ID
5193107571
Group Practice PAC ID
4385737311
Professional Enrollment ID
I20250718000582
Address ID
TN383583448MI6041XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:3State licenses:1Digital endpointsOther names

939 FAMILY PRACTICE in MS

Provider Addresses for JACKSON TEER (DO)

  • 1665 S GREEN ST

    TUPELO, MS 388046556

    Phone: (662) 377-2189

    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 7 Open Payments records for all available years, with a total value of $130.

Total Amount is formed as General ($130) + Research ($0) + Ownership ($0) = $130.

Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($46).

Total Amount

$130

General + Research + Ownership

Payments

7

Total payment records

General Amount

$130

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-20

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: 2025-07-18

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
I20250718000582IFamily PracticeTNTBD

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 38804)

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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: 4385737311View full group profile
NameSpecialtyState
Family PracticeTN
Family PracticeTN
Family PracticeTN
Family PracticeTN
Nurse PractitionerTN

Reviews

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Frequently asked questions

What is the standard ID for JACKSON TEER (DO) in the U.S.?
In the U.S., JACKSON TEER (DO) is identified by NPI 1861124331.
Does the public listing show JACKSON TEER (DO) as active?
JACKSON TEER (DO)'s NPI record reflects an active status in NPPES.
What services align with JACKSON TEER (DO)'s listing?
JACKSON TEER (DO)'s public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to JACKSON TEER (DO)?
The directory associates JACKSON TEER (DO) with Tupelo, Mississippi. Check all listed addresses for suites or satellite offices.
Who maintains JACKSON TEER (DO)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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