CASEY GORDON JACKSON (M.D.) – Internal Medicine Physician, NPI 1104834555

CASEY GORDON JACKSON (M.D.) is a healthcare provider. based in Memphis, Tennessee. specializing in INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. 41430 (TN). The NPI Number for CASEY GORDON JACKSON (M.D.) is 1104834555

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
CASEY GORDON JACKSON (M.D.)
NPI
1104834555
Phone
(901) 515-5000
Address
4095 AMERICAN WAY
Enumeration Date
3 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5032575500
Graduation Year
2003 (23 years ago)
PAC ID
5597868828
Group Practice PAC ID
8921233933
Professional Enrollment ID
I20200520003238
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,527 INTERNAL MEDICINE in TN

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Provider Addresses for CASEY GORDON JACKSON (M.D.)

  • 4095, American Way, Memphis, Shelby County, Tennessee, 38118, United States

    MEMPHIS, TN 381188339

    Phone: (901) 515-5000

    Fax: (901) 375-0982

    Type: Location

  • Regional Medical Center, 877, Jefferson Avenue, Medical District, Dixie Homes, Memphis, Shelby County, Tennessee, 38103, United States

    5TH FLOOR ADAMS PAVILION

    MEMPHIS, TN 381032807

    Phone: (901) 515-4529

    Fax: (901) 515-4599

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2009-10-22

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
I20091022000461IInternal MedicineCATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes264124$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes238132$0
99239Hospital discharge day management, more than 30 minutes143140$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes7474$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 38118)

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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: 8921233933View full group profile
NameSpecialtyState
Family PracticeME
Cardiovascular Disease (Cardiology)VA
Nurse PractitionerMA
-SC
Internal MedicineND
Family PracticeND
-VA
Physician AssistantMA
Internal MedicineOR
-CA

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Frequently asked questions

Where can patients find CASEY GORDON JACKSON (M.D.)'s NPI?
You can confirm CASEY GORDON JACKSON (M.D.) with NPI 1104834555; it appears in the national provider directory.
Is CASEY GORDON JACKSON (M.D.) currently active in the NPI registry?
CMS-published data lists CASEY GORDON JACKSON (M.D.) as an active registrant.
What field does CASEY GORDON JACKSON (M.D.) work in?
You can think of CASEY GORDON JACKSON (M.D.) as practicing within Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What location shows for CASEY GORDON JACKSON (M.D.)?
We surface Memphis, Tennessee for CASEY GORDON JACKSON (M.D.) based on available NPPES addresses.
What if Memphis, Tennessee seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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