ELIZABETH R JACKSON (N.P.) – Family Nurse Practitioner, NPI 1316143282
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,566 NURSE PRACTITIONER in MS
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Provider Addresses for ELIZABETH R JACKSON (N.P.)
9025 US HIGHWAY 64
LAKELAND, TN 380027981
Phone: (615) 425-4295
Type: Mailing
176, Goodman Road West, Southaven, DeSoto County, Mississippi, 38671, United States
SOUTHAVEN, MS 386719405
Phone: (662) 536-1020
Fax: (662) 536-1024
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $126.
Total Amount is formed as General ($126) + Research ($0) + Ownership ($0) = $126.
Last reported payment date: 2024-07-29 • Largest payer in this snapshot: Novo Nordisk Inc ($107).
Total Amount
$126
General + Research + Ownership
Payments
2
Total payment records
General Amount
$126
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $107 |
| Boston Scientific Corporation | $18 |
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: 2008-10-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20040210000523 | I | Nurse Practitioner | TN | TBD |
| I20081013000398 | I | Nurse Practitioner | MS | 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 |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 68 | 15 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 38 | 33 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 33 | 23 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 28 | 13 | $0 |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 22 | 21 | $0 |
Insurance plans in this area (ZIP 38002)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TN | |
| Nurse Practitioner | TN | |
| - | TN | |
| - | TN | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | TN | |
| Physician Assistant | IL | |
| Physician Assistant | TN |
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