Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. TIMOTHY D JACKSON MD, SA-C
NPI 1093710089
Orthopaedic Surgery in Gulfport, MS

Active since June 16, 2005PECOS Enrolled
1397 BROAD AVE, GULFPORT, MS 39501(228) 575-1945(228) 575-1964 Get Directions Write a Review

NPPES record last updated: September 30, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Sep 30, 2026, Jan 14, 2026, Jun 7, 2023 and 1 more (4 updates tracked since 2023).

About Dr. Timothy D Jackson Md, Sa-c NPPES

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

DR. TIMOTHY D JACKSON MD, SA-C (NPI 1093710089) is an individual orthopaedic surgery provider in Gulfport, Mississippi, licensed in Mississippi (14510) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093710089
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. TIMOTHY D JACKSONCredential: MD, SA-C
Location Address1397 BROAD AVEGulfport, MS 39501-2419
Mailing AddressPo Box 1810Gulfport, MS 39502-1810 · (228) 575-1945 · Fax (228) 575-1964
Fax(228) 575-1964
Sole ProprietorYes
Enumeration DateJune 16, 2005
Last NPPES UpdateSeptember 30, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2026
✔ NPI 1093710089 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in MS · 14510
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1397 BROAD AVE, Gulfport, MS 39501

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Timothy D Jackson Md, Sa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39501 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$64.96 typical visit price
range $16.15 – $129.61
Typical copayment $16.24 (range $4.03 – $32.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

Orthopaedic Surgery (Orthopaedic Trauma)
1397 BROAD AVE
GULFPORT, MS 39501

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 Timothy Jackson's NPI number?

The NPI number for Timothy Jackson is 1093710089. It was assigned to this individual provider in the NPPES registry on June 16, 2005.

Where is Timothy Jackson located?

Timothy Jackson practices at 1397 Broad Ave, Gulfport, MS 39501. The listed phone number is (228) 575-1945.

What is Timothy Jackson's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Timothy Jackson enrolled in Medicare?

Yes. Timothy Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Timothy Jackson was last updated on September 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days 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.