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RICHARD T JACKSON MD
NPI 1144323163
Orthopaedic Surgery in Provo, UT

Active since September 06, 2006PECOS Enrolled
1055 N 500 W, SUITE 121, PROVO, UT 84604(801) 373-7350(801) 812-5401 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 15, 2020, Nov 2, 2018 (2 updates tracked since 2018).

About Richard T Jackson Md NPPES

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

RICHARD T JACKSON MD (NPI 1144323163) is an individual orthopaedic surgery provider in Provo, Utah, licensed in Utah (158498-1205) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1144323163
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameRICHARD T JACKSONCredential: MD
Location Address1055 N 500 W, SUITE 121Provo, UT 84604-3305
Mailing Address1055 N 500 W, Credentialing DepartmentProvo, UT 84604-3305 · (801) 354-8225 · Fax (801) 418-0941
Phone(801) 373-7350
Fax(801) 812-5401
Sole ProprietorNo
Enumeration DateSeptember 6, 2006
Last NPPES UpdateNovember 27, 20232 updates tracked since enumeration
NPPES CertifiedApril 15, 2020
✔ NPI 1144323163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in UT · 158498-1205
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.
1055 N 500 W, Provo, UT 84604
Open in Google Maps ↗

Other Identifiers 8

Other36165UT · Dmba
Medicaid870281028000UT
Other870281028RCHUT · Emia
OtherQM000056630UT · Altius
Other107004917104UT · Ihc
Other09-00376UT · Utah Healthcare
Other20045125UT · Palmetto
Other68073UT · Pehp

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Richard T Jackson Md 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.

Medicare Billing Reassignment

Medicare enrollment records show Richard Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Revere Health PC
5.6 mi
Multi-Specialty
1055 N 500 W
Provo, UT 84604
  • Reassigned Medicare billing, Utah enrollment
  • 414 clinicians in this Medicare group
NPI 1093764805 (801) 429-8000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84604 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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 20

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

ASHLEY SAUNDERS
Family Medicine
1055 N 500 W
PROVO, UT 84604
Utah County (801) 812-5033
CRYSTAL C HUFFAKER FNP
Nurse Practitioner (Family)
1055 N 500 W, STE 211, BUILDING C
PROVO, UT 84604
Utah County (801) 357-7327
SCOTT DELAFIELD EVANS MD
Orthopaedic Surgery (Hand Surgery)
1055 N 500 W, STE 121, BUILDING C
PROVO, UT 84604
Utah County (801) 373-7350
EVAN SCOTT NIELSEN MD
Orthopaedic Surgery
1055 N 500 W, STE 121
PROVO, UT 84604
Utah County (801) 373-7350
ROSANNE JOHNSON OLIVER FNP
Nurse Practitioner (Family)
1055 N 500 W, STE 205
PROVO, UT 84604
Utah County (801) 429-8095
LESLEE RONALD ADAMS NP
Nurse Practitioner (Family)
1055 N 500 W, STE 211
PROVO, UT 84604
Utah County (801) 357-7327
WYATT JAMES BOLES DO
Family Medicine
1055 N 500 W, BLDG A
PROVO, UT 84604
Utah County (801) 812-5033
DR. REX F RIPPLINGER MD
Internal Medicine
1055 N 500 W
PROVO, UT 84604
Utah County (801) 429-8000

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 Richard Jackson's NPI number?

The NPI number for Richard Jackson is 1144323163. It was assigned to this individual provider in the NPPES registry on September 6, 2006.

Where is Richard Jackson located?

Richard Jackson practices at 1055 N 500 W Suite 121, Provo, UT 84604. The listed phone number is (801) 373-7350.

What is Richard Jackson's specialty?

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

Is Richard Jackson enrolled in Medicare?

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

Which organization bills Medicare for Richard Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Richard Jackson reassigns Medicare benefits to Revere Health PC (Provo, UT). The 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 Richard Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Richard Jackson was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.