TAMIKO JACKSON
NPI 1063875474
Nurse Practitioner - Family in Myrtle Beach, SC

Q: What is Tamiko Jackson's NPI number?

The NPI number for Tamiko Jackson is 1063875474. It was assigned to this individual provider in the NPPES registry on April 1, 2016.

Q: What is Tamiko Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Tamiko Jackson was last updated on January 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since April 01, 2016PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

920 DOUG WHITE DR STE 510, MYRTLE BEACH, SC 29572(843) 497-7772(843) 848-7530 Get Directions Write a Review

NPPES record last updated: January 27, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 27, 2022, Feb 10, 2020, Apr 1, 2016 (3 updates tracked since 2016).

On this page

About Tamiko Jackson NPPES

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

TAMIKO JACKSON (NPI 1063875474) is an individual family provider in Myrtle Beach, South Carolina, licensed in South Carolina (20057) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, is affiliated with Grand Strand Regional Medical Center, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1063875474

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameTAMIKO JACKSON

Location Address920 DOUG WHITE DR STE 510Myrtle Beach, SC 29572-4183

Mailing Address920 Doug White Dr Ste 510Myrtle Beach, SC 29572-4183 · (843) 497-7772 · Fax (843) 848-7530

Phone(843) 497-7772

Fax(843) 848-7530

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateApril 1, 2016

Last NPPES UpdateJanuary 27, 20223 updates tracked since enumeration

NPPES CertifiedFebruary 10, 2020

✔ NPI 1063875474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in SC · 20057

920 DOUG WHITE DR STE 510, Myrtle Beach, SC 29572

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.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

Tamiko Jackson 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 ID7012209885

PECOS Enrollment IDI20160714002027

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 2

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

184 services168 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

150 services146 patients

Hospital Affiliations CMS Care Compare

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

Grand Strand Regional Medical Center

Acute Care Hospitals · Myrtle Beach, SC

3/5 CMS rating

OwnershipProprietary

CMS Certification Number420085

Location809 82nd ParkwayMyrtle Beach, SC 29572 · Horry County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29572 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

e-Prescribing

93%86 patients2/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

100%98 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Automatic external defibrillator, with integrated electrocardiogram analysis, garment type K0606

DME-Other DME · category DE013N

1 supplier15 claims15 services$2,444.12 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MORGAN OVERTON PHILLIPS PA-C

Physician Assistant