DR. JASON JACKSON DO
NPI 1104628114
Student in an Organized Health Care Education/Training Program in Jackson, MS

Q: What is Jason Jackson's NPI number?

The NPI number for Jason Jackson is 1104628114. It was assigned to this individual provider in the NPPES registry on March 27, 2025.

Q: What is Jason Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jason Jackson was last updated on March 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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 March 27, 2025PECOS Enrolled

2500 N STATE ST, JACKSON, MS 39216(601) 984-1000 Get Directions Write a Review

NPPES record last updated: March 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jason Jackson Do NPPES

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

DR. JASON JACKSON DO (NPI 1104628114) is an individual student in an organized health care education/training program in Jackson, Mississippi and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104628114

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. JASON JACKSONCredential: DO

Location Address2500 N STATE STJackson, MS 39216-4500

Mailing Address2500 N State StJackson, MS 39216-4500

Phone(601) 984-1000

Sole ProprietorNo

Enumeration DateMarch 27, 2025

Last NPPES UpdateMarch 28, 2025

NPPES CertifiedMarch 28, 2025

✔ NPI 1104628114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2500 N STATE ST, Jackson, MS 39216

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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. Jason Jackson Do 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.

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.

LAMAR DAVIS II M.D.

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)