DR. MARK R. JACKSON MD
NPI 1003877077
Emergency Medicine - Emergency Medical Services in Tooele, UT

Active since March 30, 2006PECOS EnrolledAccepts Medicare Assignment
1474 E ERDA WAY, TOOELE, UT 84074(435) 849-0779 Get Directions Write a Review

NPPES record last updated: March 21, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Mark R. Jackson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK R. JACKSON MD (NPI 1003877077) is an individual emergency medical services provider in Tooele, Utah, licensed in Utah (5929640-1205) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Northern Rockies Medical Center, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1003877077
Entity TypeIndividualMale
Primary Taxonomy207PE0004X
Provider Legal NameDR. MARK R. JACKSONCredential: MD
Location Address1474 E ERDA WAYTooele, UT 84074-9737
Mailing Address1474 E Erda WayTooele, UT 84074-9737 · (435) 849-0779
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateMarch 30, 2006
Last NPPES UpdateMarch 21, 2016
NPI 1003877077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEmergency Medicine · Emergency Medical ServicesAllopathic & Osteopathic Physicians
Taxonomy Code207PE0004X
License Licensed in UT · 5929640-1205
Definition
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.
1474 E ERDA WAY, Tooele, UT 84074

Other Identifiers 4

Medicare UPING78689UT
Medicare ID-Type Unspecified005568644UT · 1050 E South Temple, Slc
MedicaidD6378UT
Medicare ID-Type Unspecified005786129UT · 2055 N Main, Tooele

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Mark R. Jackson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991740599
PECOS Enrollment IDI20110609000348
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
76 services72 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
75 services74 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
14 services14 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
11 services11 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northern Rockies Medical Center

Critical Access Hospitals · Cut Bank, MT
OwnershipVoluntary non-profit - Private
CMS Certification Number271337
Location802 2nd St SECut Bank, MT 59427 · Glacier County

Cibola General Hospital

Critical Access Hospitals · Grants, NM
OwnershipVoluntary non-profit - Private
CMS Certification Number321308
Location1016 E Roosevelt AvenueGrants, NM 87020 · Cibola County
Emergency services Birthing friendly

Rehoboth Mckinley Christian Health Care Services

Critical Access Hospitals · Gallup, NM
OwnershipVoluntary non-profit - Private
CMS Certification Number321313
Location1901 Red Rock DriveGallup, NM 87301 · Mckinley County
Emergency services

Nacogdoches Memorial Hospital

Acute Care Hospitals · Nacogdoches, TX
1/5 CMS rating
OwnershipProprietary
CMS Certification Number450508
Location1204 Mound StNacogdoches, TX 75961 · Nacogdoches County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84074 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Jackson's NPI number?

The NPI number for Mark Jackson is 1003877077. It was assigned to this individual provider in the NPPES registry on March 30, 2006.

Where is Mark Jackson located?

Mark Jackson practices at 1474 E Erda Way, Tooele, UT 84074. The listed phone number is (435) 849-0779.

What is Mark Jackson's specialty?

The primary specialty registered for this NPI is Emergency Medicine, specializing in Emergency Medical Services, with taxonomy code 207PE0004X.

Is Mark Jackson enrolled in Medicare?

Yes. Mark Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mark Jackson accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan, Ambetter of Oklahoma and Blue Cross and Blue Shield of Texas list Mark Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mark Jackson affiliated with any hospitals?

According to CMS data, Mark Jackson is affiliated with Northern Rockies Medical Center, Cibola General Hospital, Rehoboth Mckinley Christian Health Care Services and Nacogdoches Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Mark Jackson was last updated on March 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.