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MR. TIMOTHY LAWRENCE JACKSON PA
NPI 1124338504
Physician Assistant - Medical in Williams, AZ

Active since October 19, 2010PECOS Enrolled
70.58/100
CMS Quality Rating
300 S 6TH ST, WILLIAMS, AZ 86046(928) 635-4441 Get Directions Write a Review

NPPES record last updated: July 21, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Timothy Lawrence Jackson Pa NPPES

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

MR. TIMOTHY LAWRENCE JACKSON PA (NPI 1124338504) is an individual medical provider in Williams, Arizona, licensed in Arizona (5407) and active in the NPI registry since October 2010. He is enrolled in Medicare PECOS and maintains a secondary practice location in Flagstaff.

NPPES Registry Identity

NPI1124338504
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. TIMOTHY LAWRENCE JACKSONCredential: PA
Location Address300 S 6TH STWilliams, AZ 86046-0110
Mailing AddressPo Box 3630Flagstaff, AZ 86003-3630
Phone(928) 635-4441
Sole ProprietorYes
Enumeration DateOctober 19, 2010
Last NPPES UpdateJuly 21, 2021
NPPES CertifiedJuly 21, 2021
✔ NPI 1124338504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in AZ · 5407
300 S 6TH ST, Williams, AZ 86046
Open in Google Maps ↗

Secondary Practice Location 1

Location 12722 N Mariah WayFlagstaff, AZ 86004-7550 · Phone (928) 527-7759

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Timothy Lawrence Jackson Pa 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.

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.

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.
41 services39 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.
14 services14 patients

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.

70.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality39.68
Promoting Interoperability79
Improvement Activities40
Cost63.1

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.

KATHERINE MORRIS PA
Physician Assistant (Medical)
300 S 6TH ST
WILLIAMS, AZ 86046
Coconino County (928) 635-4441
TRASI LYNN CRUMRIN D.O.
Family Medicine
300 S 6TH ST
WILLIAMS, AZ 86046
Coconino County (928) 635-4441
NORTH COUNTRY HEALTHCARE INC. WILLIAMS URGENT CARE
Clinic/Center (Federally Qualified Health Center (FQHC))
300 S 6TH ST
WILLIAMS, AZ 86046
Coconino County (928) 635-4441
DR. SARAH A. NOTTER M.D.
Internal Medicine
300 S 6TH ST
WILLIAMS, AZ 86046
Coconino County (928) 635-4441
DR. TYLER ARKLESS M.D.
Family Medicine
300 S 6TH ST
WILLIAMS, AZ 86046
Coconino County (928) 635-4441
ELIZABETH DAWN HAWS FNP-C
Nurse Practitioner
300 S 6TH ST
WILLIAMS, AZ 86046
Coconino County (928) 635-4441
MARIA ARGANOZA-PRIESS DO
Family Medicine
300 S 6TH ST
WILLIAMS, AZ 86046
Coconino County (928) 635-4441
DR. IMAC SORAYA REYNAGA HOLMES ED.D M.S. LPC LCADC
Counselor (Professional)
300 S 6TH ST
WILLIAMS, AZ 86046
Coconino County (928) 635-4441

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 1124338504. It was assigned to this individual provider in the NPPES registry on October 19, 2010.

Where is Timothy Jackson located?

Timothy Jackson practices at 300 S 6th St, Williams, AZ 86046. The listed phone number is (928) 635-4441.

What is Timothy Jackson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Timothy Jackson enrolled in Medicare?

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

What insurance does Timothy Jackson accept?

Health plans from Blue Cross Blue Shield of Arizona list Timothy 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.

When was this NPI record last updated?

The NPPES record for Timothy Jackson was last updated on July 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.