RANDALL JACKSON CFNP
NPI 1144614165
Nurse Practitioner - Acute Care in Mccomb, MS

Q: What is Randall Jackson's NPI number?

The NPI number for Randall Jackson is 1144614165. It was assigned to this individual provider in the NPPES registry on March 27, 2015.

Q: What is Randall Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Randall Jackson was last updated on May 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 27, 2015PECOS EnrolledAccepts Medicare Assignment

215 MARION AVE, MCCOMB, MS 39648(601) 249-5500(601) 249-1173 Get Directions Write a Review

NPPES record last updated: May 2, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Randall Jackson Cfnp NPPES

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

RANDALL JACKSON CFNP (NPI 1144614165) is an individual acute care provider in Mccomb, Mississippi, licensed in Mississippi (878547) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS, is affiliated with Southwest Ms Regional Medical Center, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1144614165

Entity TypeIndividualMale

Primary Taxonomy363LA2100X

Provider Legal NameRANDALL JACKSONCredential: CFNP

Location Address215 MARION AVEMccomb, MS 39648-2705

Mailing AddressPo Box 490Mccomb, MS 39649-0490 · (601) 249-2701 · Fax (601) 249-2195

Phone(601) 249-5500

Fax(601) 249-1173

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateMarch 27, 2015

Last NPPES UpdateMay 2, 2022

NPPES CertifiedMay 2, 2022

✔ NPI 1144614165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in MS · 878547

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License R878547 (MS)

215 MARION AVE, Mccomb, MS 39648

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Other Identifiers 1

Medicaid05435530MS

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Randall Jackson Cfnp 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.

PECOS PAC ID8628396736

PECOS Enrollment IDI20150421000238

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 3

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

138 services63 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

47 services43 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

42 services40 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Southwest Ms Regional Medical Center

Acute Care Hospitals · Mccomb, MS

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number250097

Location215 Marion Av Box 1307Mccomb, MS 39649 · Pike County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39648 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

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier38 claims38 services$19.03 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

2 suppliers13 claims13 services$785.49 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier38 claims38 services$106.66 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

AARTI VADALIA MD

Student in an Organized Health Care Education/Training Program