1. Home
  2. Directory
  3. Mississippi
  4. Collinsville
  5. Nurse Practitioner
  6. NPI Profile

GLORIA J. JACKSON FNP
NPI 1245213354
Nurse Practitioner - Family in Collinsville, MS

Active since November 22, 2005PECOS Enrolled
9097 COLLINSVILLE RD, COLLINSVILLE, MS 39325(601) 626-8874(601) 626-8592 Get Directions Write a Review

NPPES record last updated: November 6, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Gloria J. Jackson Fnp NPPES

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

GLORIA J. JACKSON FNP (NPI 1245213354) is an individual family provider in Collinsville, Mississippi, licensed in Mississippi (R715654) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245213354
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameGLORIA J. JACKSONCredential: FNP
Location Address9097 COLLINSVILLE RDCollinsville, MS 39325-9779
Mailing AddressPo Box 2106Meridian, MS 39302-2106 · (601) 703-4282 · Fax (601) 703-4597
Phone(601) 626-8874
Fax(601) 626-8592
Sole ProprietorNo
Enumeration DateNovember 22, 2005
Last NPPES UpdateNovember 6, 2013
✔ NPI 1245213354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MS · R715654
9097 COLLINSVILLE RD, Collinsville, MS 39325
Open in Google Maps ↗

Other Identifiers 5

Other730-15594Blue Cross Of Al
Medicare UPINQ49469
Medicaid09573377MS
Medicare ID-Type Unspecified500001935
Medicaid891010060AL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gloria J. Jackson Fnp 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 Gloria Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mdb Behavioral Health Services LLC
118 mi
Rural Health
1911 MISSION 66 STE B
Vicksburg, MS 39180
  • Reassigned Medicare billing, Mississippi enrollment
  • 180 clinicians in this Medicare group
NPI 1669835310 (601) 665-4162

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 39325 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.

Other Providers at the Same Location NPPES 5

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

LAIRD HOSPITAL, INC
Clinic/Center (Rural Health)
9097 COLLINSVILLE RD
COLLINSVILLE, MS 39325
Lauderdale County (601) 626-8874
LABORATORY CORPORATION OF AMERICA HOLDINGS
Clinical Medical Laboratory
9097 COLLINSVILLE RD
COLLINSVILLE, MS 39325
Lauderdale County (601) 626-0322
DR. EDWARD DANIEL HENDERSON JR. M.D.
Family Medicine
9097 COLLINSVILLE RD
COLLINSVILLE, MS 39325
Lauderdale County (601) 626-8874
KRISTEN THAMES FNP-C
Nurse Practitioner (Family)
9097 COLLINSVILLE RD
COLLINSVILLE, MS 39325
Lauderdale County (601) 626-8874
LAURA RENEA HARDY
Nurse Practitioner (Family)
9097 COLLINSVILLE RD
COLLINSVILLE, MS 39325
Lauderdale County (601) 626-8874

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 Gloria Jackson's NPI number?

The NPI number for Gloria Jackson is 1245213354. It was assigned to this individual provider in the NPPES registry on November 22, 2005.

Where is Gloria Jackson located?

Gloria Jackson practices at 9097 Collinsville Rd, Collinsville, MS 39325. The listed phone number is (601) 626-8874.

What is Gloria Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Gloria Jackson enrolled in Medicare?

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

Which organization bills Medicare for Gloria Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gloria Jackson reassigns Medicare benefits to Mdb Behavioral Health Services LLC (Vicksburg, MS). 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 Gloria 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 Gloria Jackson was last updated on November 6, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.