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JACKSON CLINIC PA
NPI 1285629386
Internal Medicine in Jackson, TN

Active since September 14, 2005CLIA Certified · 11 labs
2863 HIGHWAY 45 BYP, JACKSON, TN 38305(731) 664-1375(731) 664-1378 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 10, 2025, Mar 5, 2025, Oct 10, 2024 and 4 more (7 updates tracked since 2015).

About Jackson Clinic Pa NPPES

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

JACKSON CLINIC PA (NPI 1285629386) is a healthcare organization registered as an internal medicine in Jackson, Tennessee and active in the NPI registry since September 2005. The organization holds 11 active CLIA laboratory certificates, maintains 12 additional practice locations, and lists Mark Allen, C.e.o., as its authorized official.

NPPES Registry Identity

NPI1285629386
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameJACKSON CLINIC PA
Location Address2863 HIGHWAY 45 BYPJackson, TN 38305-3618
Mailing AddressPo Box 400Jackson, TN 38302-0400 · (731) 423-8697 · Fax (731) 422-5743
Phone(731) 664-1375
Fax(731) 664-1378
Organization SubpartNo
Authorized OfficialMark AllenC.e.o. · (731) 422-0203
Enumeration DateSeptember 14, 2005
Last NPPES UpdateSeptember 10, 20257 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2025
✔ NPI 1285629386 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPsychologistTaxonomy 103T00000X
Also ListedDietitian, RegisteredTaxonomy 133V00000X
Also ListedOptometristTaxonomy 152W00000X
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X
Also ListedInternal Medicine · GastroenterologyTaxonomy 207RG0100X
Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X
Also ListedInternal Medicine · Infectious DiseaseTaxonomy 207RI0200X
Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedOphthalmologyTaxonomy 207W00000X
2863 HIGHWAY 45 BYP, Jackson, TN 38305
Open in Google Maps ↗

Secondary Practice Locations 12

Location 14039 Highland StMilan, TN 38358-3483 · Phone (731) 422-0213
Location 2101 Garrett DrMedina, TN 38355-9641 · Phone (731) 422-0213 · Fax (731) 462-5070
Location 3622 W Market StBolivar, TN 38008-2201 · Phone (731) 422-0213
Location 42859 Highway 45 BypJackson, TN 38305-3618 · Phone (731) 422-0213
Location 5145 Innovation DrJackson, TN 38305-3019 · Phone (731) 422-0213
Location 687 Murray Guard Dr Ste BJackson, TN 38305-3775 · Phone (731) 422-0213
Location 71863 S Highland AveJackson, TN 38301-7799 · Phone (731) 422-0213
Location 868 EXETER RDJACKSON, TN 38305-1829 · Phone (731) 422-0213 · Fax (731) 868-4871
Location 9149 COMMONS DRMARTIN, TN 38237-3882 · Phone (731) 422-0213
Location 1022 2nd AveHuntingdon, TN 38344-3806 · Phone (731) 422-0213 · Fax (731) 868-4766
Location 11619 Skyline DrJackson, TN 38301-3903 · Phone (731) 422-0213 · Fax (731) 882-5052
Location 123568 Chere Carol RdHumboldt, TN 38343-3639 · Phone (731) 422-0213

Other Identifiers 1

Medicaid3370007TN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackson Clinic Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

183

Medicare enrollment records show 183 clinicians reassign Medicare billing to Jackson Clinic PA, which bills Medicare for the services they deliver. Of these, 36 practice at this address and 155 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 29

Nurse Practitioner50
Family Practice31
Diagnostic Radiology21
Internal Medicine17
Obstetrics/Gynecology13
Physical Therapist in Private Practice7
Nephrology5
Interventional Cardiology4
21 other specialties35

Nearest to this location (20)

See all 183
Siddique Akbar, MD
Nephrology
NPI 1295290328
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Marshall Banks, M.D.
Internal Medicine
NPI 1104811249
2863 HWY 45 BYP.
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Gloria Brien, R.D.
Registered Dietitian or Nutrition Professional
NPI 1982867313
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ Accepts MedicareSame address
Joel Brunson, APN
Nurse Practitioner
NPI 1043519705
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Sameer Dawoodi, M.D.
Gastroenterology
NPI 1326509498
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Emily Fitts
Nurse Practitioner
NPI 1942960018
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Robert Gilroy, M.D.
Pulmonary Disease
NPI 1629063227
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Joseph Gooch, M.D.
Family Practice
NPI 1659613628
2863 HIGHWAY 45 BYP.
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Dana Hager, M.D.
Pulmonary Disease
NPI 1992772255
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Amy Lawrence, FNP
Nurse Practitioner
NPI 1003676198
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Natasha Mahajan, MD
Internal Medicine
NPI 1174590251
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Yasmin Mahmoud
Nephrology
NPI 1326668963
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(718) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Mark Milone, MD
Gastroenterology
NPI 1881635803
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ PECOSSame address
Victor Nwazue, M.D.
Nephrology
NPI 1861657561
2863 HIGHWY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Khamoshi Patel, DO
Internal Medicine
NPI 1912559972
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(313) 642-4990
✔ PECOS✔ Accepts MedicareSame address
Jessica Strickland, MS, RD, LDN
Registered Dietitian or Nutrition Professional
NPI 1154674208
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ Accepts MedicareSame address
Casey Zelus, MD
Infectious Disease
NPI 1801316583
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 422-0213
✔ PECOS✔ Accepts MedicareSame address
Leila Nichols, CNM
Certified Nurse Midwife (CNM)
NPI 1104159904
2863 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 660-8300
✔ PECOS✔ Accepts MedicareSame address
Joseph Ragon, MD
Family Practice
NPI 1275501702
2859 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 660-8360
✔ PECOS✔ Accepts MedicareSame address
Amanda Reiter, MD
Family Practice
NPI 1629046156
2859 HIGHWAY 45 BYP
Jackson, TN 38305
(731) 660-8360
✔ PECOS✔ Accepts MedicareSame address
See all 183 clinicians

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

CLIA Laboratory Certificates CMS CLIA 11

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 44D0029144

Jackson Clinic, PA North Convenient Care, The · Jackson, TN
Active · expires Oct 3, 2028
CLIA Number44D0029144
Laboratory TypePhysician Office
Certificate Effective DateOctober 4, 2026
Certificate Expiration DateOctober 3, 2028
Laboratory DirectorDr. Bryan Tygart
Laboratory Phone(731) 664-8360
Laboratory LocationJackson Clinic, PA North Convenient Care, The2859 Hwy 45 Bypass, Jackson, TN 38305
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 44D0700598

Jackson Clinic PA Of Humboldt,the · Humboldt, TN
Active · expires Jul 26, 2028
CLIA Number44D0700598
Laboratory TypePhysician Office
Certificate Effective DateJuly 27, 2026
Certificate Expiration DateJuly 26, 2028
Laboratory DirectorDr. Keith H. Kirby
Laboratory Phone(731) 784-2202
Laboratory LocationJackson Clinic PA Of Humboldt,the3568 Chere Carol Road, Humboldt, TN 38343
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 44D2168592

Jackson Clinic, PA Convenient Care Medina, The · Medina, TN
Active · expires Feb 12, 2028
CLIA Number44D2168592
Laboratory TypePhysician Office
Certificate Effective DateFebruary 13, 2026
Certificate Expiration DateFebruary 12, 2028
Laboratory DirectorAmy C. Barber
Laboratory Phone(731) 422-0355
Laboratory LocationJackson Clinic, PA Convenient Care Medina, The101 Garrett Dr, Medina, TN 38355
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 44D2025887

Jackson Clinic, PA - Innovation Park, The Dba The Jackson Clinic, PA · Jackson, TN
Active · expires Jan 26, 2028
CLIA Number44D2025887
Laboratory TypeIndependent
Certificate Effective DateJanuary 27, 2026
Certificate Expiration DateJanuary 26, 2028
Laboratory DirectorDr. Frances Cate
Laboratory Phone(731) 422-0250
Laboratory LocationJackson Clinic, PA - Innovation Park, The Dba The Jackson Clinic, PA145 Innovation Drive, Jackson, TN 38305
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 44D2322444

Jackson Clinic, PA - Martin, The · Martin, TN
Active · expires Oct 16, 2027
CLIA Number44D2322444
Laboratory TypePhysician Office
Certificate Effective DateOctober 17, 2025
Certificate Expiration DateOctober 16, 2027
Laboratory DirectorDr. Cynthia R. Swaim
Laboratory Phone(731) 422-0467
Laboratory LocationJackson Clinic, PA - Martin, The149 Commons Drive, Martin, TN 38237
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 44D2008800

Jackson Clinic, PA Bolivar, The · Bolivar, TN
Active · expires Sep 2, 2027
CLIA Number44D2008800
Laboratory TypePhysician Office
Certificate Effective DateSeptember 3, 2025
Certificate Expiration DateSeptember 2, 2027
Laboratory DirectorAmy C. Barber
Laboratory Phone(731) 658-2885
Laboratory LocationJackson Clinic, PA Bolivar, The622 West Market Street, Bolivar, TN 38008
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Jackson Clinic PA's NPI number?

The NPI number for Jackson Clinic PA is 1285629386. It was assigned to this organization in the NPPES registry on September 14, 2005.

Where is Jackson Clinic PA located?

Jackson Clinic PA is located at 2863 Highway 45 Byp, Jackson, TN 38305. The listed phone number is (731) 664-1375.

What is Jackson Clinic PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jackson Clinic PA enrolled in Medicare?

Yes. Jackson Clinic PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jackson Clinic PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 183 clinicians in 29 Medicare specialties reassign their Medicare billing to Jackson Clinic PA. A 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 the clinician's services. The largest specialties are Nurse Practitioner (50), Family Practice (31) and Diagnostic Radiology (21). Of these, 36 practice at this address and 155 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Jackson Clinic PA hold CLIA laboratory certificates?

Yes. 11 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Jackson Clinic PA accept?

Health plans from Cigna Healthcare list Jackson Clinic PA 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.

When was this NPI record last updated?

The NPPES record for Jackson Clinic PA was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.