TARA NAOMI JACKSON (DO) – Family Medicine Physician, NPI 1770072332
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,775 FAMILY PRACTICE in OK
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Provider Addresses for TARA NAOMI JACKSON (DO)
1100, North 9th Street, Hartshorne, Pittsburg County, Oklahoma, 74547, United States
OKLAHOMA CITY, OK 731021015
Phone: (405) 231-3000
Fax: (405) 231-3037
Type: Mailing
1137 INDEPENDENCE DR
WEST PLAINS, MO 657754221
Phone: (417) 255-8464
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $191.
Total Amount is formed as General ($191) + Research ($0) + Ownership ($0) = $191.
Last reported payment date: 2024-09-26 • Largest payer in this snapshot: Dexcom, Inc. ($73).
Total Amount
$191
General + Research + Ownership
Payments
11
Total payment records
General Amount
$191
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dexcom, Inc. | $73 |
| Novo Nordisk Inc | $39 |
| Merck Sharp & Dohme LLC | $34 |
| Amgen Inc. | $18 |
| AstraZeneca Pharmaceuticals LP | $14 |
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: 2021-08-18
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210818001442 | I | Family Practice | MO | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 73102)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| Family Practice | NV | |
| - | MO | |
| Internal Medicine | MO | |
| Nurse Practitioner | MO | |
| Clinical Social Worker | MO | |
| - | MS | |
| - | MO | |
| Clinical Social Worker | MO | |
| Nurse Practitioner | MO |
Reviews
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