DR. TIMOTHY K JACKSON M. D.
NPI 1255444766
Internal Medicine - Endocrinology, Diabetes & Metabolism in Bridgeport, WV

Q: What is Timothy Jackson's NPI number?

The NPI number for Timothy Jackson is 1255444766. It was assigned to this individual provider in the NPPES registry on August 17, 2006.

Q: What is Timothy Jackson's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Q: When was this NPI record last updated?

The NPPES record for Timothy Jackson was last updated on April 6, 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 August 17, 2006PECOS Enrolled

94.1/100

CMS Quality Rating

710 GENESIS BLVD, BRIDGEPORT, WV 26330(681) 342-3070 Get Directions Write a Review

NPPES record last updated: April 6, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 6, 2022, Dec 31, 2020, Jun 16, 2020 (3 updates tracked since 2020).

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About Dr. Timothy K Jackson M. D. NPPES

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

DR. TIMOTHY K JACKSON M. D. (NPI 1255444766) is an individual endocrinology, diabetes & metabolism provider in Bridgeport, West Virginia, licensed in West Virginia (13532) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Morgantown.

NPPES Registry Identity

NPI1255444766

Entity TypeIndividualMale

Primary Taxonomy207RE0101X

Provider Legal NameDR. TIMOTHY K JACKSONCredential: M. D.

Location Address710 GENESIS BLVDBridgeport, WV 26330-9668

Mailing AddressPo Box 763Morgantown, WV 26507-0763 · (800) 541-4009

Phone(681) 342-3070

Sole ProprietorNo

Enumeration DateAugust 17, 2006

Last NPPES UpdateApril 6, 20223 updates tracked since enumeration

NPPES CertifiedApril 6, 2022

✔ NPI 1255444766 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians

Taxonomy Code207RE0101X

License✔ Licensed in WV · 13532

Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

710 GENESIS BLVD, Bridgeport, WV 26330

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Secondary Practice Location 1

Location 11 Stadium DriveMorgantown, WV 26507 · Phone (304) 598-4800 · Fax (304) 293-6963

Other Identifiers 1

Medicaid0084315000WV

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Timothy K Jackson M. D. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26330 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

$124.46 typical visit price

range $53.20 – $164.59

Typical copayment $31.11 (range $13.30 – $41.14)

Most-billed visit code 99204

Established Patient

$94.81 typical visit price

range $16.47 – $133.29

Typical copayment $23.70 (range $4.11 – $33.32)

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.

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.

94.1/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

78.46

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 5

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

Supplies for maintenance of insulin infusion catheter, per week A4224

DME-Other DME · category DE017N

2 suppliers12 claims156 services$19.26 avg. paid by Medicare

Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225

DME-Other DME · category DE017N

2 suppliers11 claims330 services$2.41 avg. paid by Medicare

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

15 suppliers42 claims143 services$5.94 avg. paid by Medicare

External ambulatory infusion pump, insulin E0784

DME-Other DME · category DE017N

2 suppliers34 claims34 services$312.45 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

11 suppliers209 claims212 services$185.41 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 5

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

MERANDA CHIPPS NP-C

Nurse Practitioner