JACOB JACKSON (APRN, CNP) – Family Nurse Practitioner, NPI 1134629405
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,299 NURSE PRACTITIONER in OK
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Provider Addresses for JACOB JACKSON (APRN, CNP)
PO BOX 2339
ELK CITY, OK 736482339
Phone: (580) 225-2518
Fax: (580) 225-3167
Type: Mailing
105, West 1st Street, Elk City, Beckham County, Oklahoma, 73644, United States
ELK CITY, OK 736443133
Phone: (580) 225-2518
Fax: (580) 225-3167
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $72.
Total Amount is formed as General ($72) + Research ($0) + Ownership ($0) = $72.
Last reported payment date: 2024-05-14 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($30).
Total Amount
$72
General + Research + Ownership
Payments
3
Total payment records
General Amount
$72
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $30 |
| Phathom Pharmaceuticals, Inc. | $21 |
| Heron Therapeutics, Inc. | $21 |
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: 2018-04-26
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 |
|---|---|---|---|---|
| I20180426001863 | I | Nurse Practitioner | OK | 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 |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 1,466 | 106 | $0 |
Insurance plans in this area (ZIP 73648)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, Obstetrics/Gynecology | OK |
Reviews
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