GARY L JACKSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1700884947

GARY L JACKSON (CRNA) is a healthcare provider. based in Texarkana, Texas. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 231425 (TX). The NPI Number for GARY L JACKSON (CRNA) is 1700884947

Main info

Male
48 Years Of Experience
Accepts Medicare Assignment
Name
GARY L JACKSON (CRNA)
NPI
1700884947
Phone
(903) 735-9802
Address
4100 SUMMERHILL RD
Enumeration Date
12 July 2005
Last Update Date
26 July 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9036141000
Graduation Year
1978 (48 years ago)
PAC ID
1759564636
Group Practice PAC ID
2264325588
Professional Enrollment ID
I20110330000880
Address ID
TX755032372TE2600XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

5,279 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in TX

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Provider Addresses for GARY L JACKSON (CRNA)

  • 4100, Summerhill Road, Texarkana, Bowie County, Texas, 75503, United States

    TEXARKANA, TX 755032732

    Phone: (903) 735-9802

    Fax: (903) 735-9806

    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 8 Open Payments records for all available years, with a total value of $142.

Total Amount is formed as General ($142) + Research ($0) + Ownership ($0) = $142.

Last reported payment date: 2024-08-28 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($142).

Total Amount

$142

General + Research + Ownership

Payments

8

Total payment records

General Amount

$142

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-28

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$142
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: 2011-03-30

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
I20110330000880ICertified Registered Nurse Anesthetist (Crna)TXTBD

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
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope7575$0
00811Anesthesia for other procedure on large bowel using an endoscope5856$0
00812Anesthesia for exam of colon using an endoscope5353$0
00813Anesthesia for procedure on small and large bowel using an endoscope3030$0
View full utilization report →

Insurance plans in this area (ZIP 75503)

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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: 2264325588View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TN
Certified Registered Nurse Anesthetist (Crna)SC
-TX
Nurse PractitionerTX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

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Frequently asked questions

How is GARY L JACKSON (CRNA) identified in CMS data?
CMS-hosted NPPES data lists GARY L JACKSON (CRNA) with NPI 1700884947.
Is GARY L JACKSON (CRNA) still practicing?
GARY L JACKSON (CRNA) is currently listed as active in the public NPI registry.
What is GARY L JACKSON (CRNA)'s specialty?
The listing groups GARY L JACKSON (CRNA) with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What area does GARY L JACKSON (CRNA) serve?
GARY L JACKSON (CRNA)'s listing highlights Texarkana, Texas; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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