JACOB JACKSON APRN, CNP
NPI 1134629405
Nurse Practitioner - Family in Elk City, OK
About Jacob Jackson Aprn, Cnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACOB JACKSON APRN, CNP (NPI 1134629405) is an individual family provider in Elk City, Oklahoma, licensed in Oklahoma (113330) and active in the NPI registry since February 2018. He is enrolled in Medicare PECOS, is affiliated with Great Plains Regional Medical Center, and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses 2
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
Jacob Jackson Aprn, Cnp 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
2Medicare enrollment records show Jacob Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Elk City, OK 73644
- Reassigned Medicare billing, Oklahoma enrollment
- 3 clinicians in this Medicare group
Elk City, OK 73644
- Reassigned Medicare billing, Oklahoma enrollment
- 59 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 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Great Plains Regional Medical Center
Acute Care Hospitals · Elk City, OKPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 73644 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Jacob Jackson's NPI number?
The NPI number for Jacob Jackson is 1134629405. It was assigned to this individual provider in the NPPES registry on February 13, 2018.
Where is Jacob Jackson located?
Jacob Jackson practices at 1800 W 1st St Ste 105B, Elk City, OK 73644. The listed phone number is (580) 225-2518.
What is Jacob Jackson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jacob Jackson enrolled in Medicare?
Yes. Jacob 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 Jacob Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Jackson reassigns Medicare benefits to 2 organizations: Michael Robinson Medical Clinic, LLC (Elk City, OK) and Farmers Union Hospital Association (Elk City, OK). 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 Jacob Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacob Jackson accept?
Health plans from Blue Cross and Blue Shield of Oklahoma and Mending Health list Jacob 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 Jacob Jackson affiliated with any hospitals?
According to CMS data, Jacob Jackson is affiliated with Great Plains Regional Medical Center.
When was this NPI record last updated?
The NPPES record for Jacob Jackson was last updated on March 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Jacob Jackson, APRN, CNP · NPI 1134629405
Family physician in Elk City, Oklahoma. Individual provider, active in the CMS NPPES registry since February 13, 2018.
## Identity
- **NPI:** 1134629405 (Entity type: Individual)
- **Enumerated:** February 13, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 113330 (Oklahoma)
- **Sole proprietor:** No
## Practice location
- **Address:** 1800 W 1ST ST STE 105B, Elk City, OK 73644-3133
- **Phone:** (580) 225-2518 · **Fax:** (580) 225-3167
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Michael Robinson Medical Clinic, LLC (NPI 1649521568, Elk City, OK); Farmers Union Hospital Association (NPI 1184639122, Elk City, OK) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** March 26, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1134629405) · Data from the CMS NPPES public registry.