DR. MARK R. JACKSON MD
NPI 1003877077
Emergency Medicine - Emergency Medical Services in Tooele, UT
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 Cibola General Hospital, and is a graduate of Other (1995).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
9Medicare enrollment records show Mark Jackson reassigns Medicare billing to 9 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Grants, NM 87020
- Reassigned Medicare billing, New Mexico enrollment
- 123 clinicians in this Medicare group
Las Cruces, NM 88011
- Reassigned Medicare billing, New Mexico enrollment
- 238 clinicians in this Medicare group
Levelland, TX 79336
- Reassigned Medicare billing, Texas enrollment
- 122 clinicians in this Medicare group
Fairfield, TX 75840
- Reassigned Medicare billing, Texas enrollment
- 76 clinicians in this Medicare group
Fairfield, TX 75840
- Reassigned Medicare billing, Texas enrollment
- 68 clinicians in this Medicare group
Nacogdoches, TX 75961
- Reassigned Medicare billing, Texas enrollment
- 109 clinicians in this Medicare group
Many, LA 71449
- Reassigned Medicare billing, New Mexico enrollment
- 152 clinicians in this Medicare group
Crossett, AR 71635
- Reassigned Medicare billing, New Mexico enrollment
- 114 clinicians in this Medicare group
West Memphis, AR 72301
- Reassigned Medicare billing, New Mexico enrollment
- 56 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Cibola General Hospital
Critical Access Hospitals · Grants, NMNacogdoches Memorial Hospital
Acute Care Hospitals · Nacogdoches, TXPhysician 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.
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.
Which organizations bill Medicare for Mark Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mark Jackson reassigns Medicare benefits to 9 organizations: Fedko Emergency Physicians New Mexico LLC (Grants, NM), Las Cruces Hb Medical Services LLC (Las Cruces, NM), Emergency Staffing Solutions Of West Texas LLC (Levelland, TX), Ess Of Fairfield LLC (Fairfield, TX), Hcc Of Fairfield LLC (Fairfield, TX) and 4 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mark Jackson accept?
Health plans from 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 Cibola General Hospital 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.
# Dr. Mark R. Jackson, MD · NPI 1003877077
Emergency Medical Services physician in Tooele, Utah. Individual provider, active in the CMS NPPES registry since March 30, 2006.
## Identity
- **NPI:** 1003877077 (Entity type: Individual)
- **Enumerated:** March 30, 2006
- **Primary specialty:** Emergency Medicine - Emergency Medical Services · taxonomy 207PE0004X
- **State license:** 5929640-1205 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 1474 E ERDA WAY, Tooele, UT 84074-9737
- **Phone:** (435) 849-0779
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 9 organizations under Medicare reassignment (form CMS-855R): Fedko Emergency Physicians New Mexico LLC (NPI 1770047441, Grants, NM); Las Cruces Hb Medical Services LLC (NPI 1598446171, Las Cruces, NM); Emergency Staffing Solutions Of West Texas LLC (NPI 1033593504, Levelland, TX); Ess Of Fairfield LLC (NPI 1588132856, Fairfield, TX); Hcc Of Fairfield LLC (NPI 1487122750, Fairfield, TX); and 4 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1995
## Record status
- **NPPES last updated:** March 21, 2016
- **Other identifiers:** Medicare UPIN G78689 (UT); Medicare ID-Type Unspecified 005568644 (UT); Medicaid D6378 (UT); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1003877077) · Data from the CMS NPPES public registry.