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JOHN CLAUDE JACKSON D.O.
NPI 1669433546
Family Medicine in Wagoner, OK

Active since March 30, 2006PECOS Enrolled
410 E CHEROKEE ST, WAGONER, OK 74467(918) 485-5591(918) 485-5758 Get Directions Write a Review

NPPES record last updated: March 23, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 23, 2017, Mar 2, 2017 (2 updates tracked since 2017).

About John Claude Jackson D.o. NPPES

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

JOHN CLAUDE JACKSON D.O. (NPI 1669433546) is an individual family medicine provider in Wagoner, Oklahoma, licensed in Oklahoma (1672) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669433546
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJOHN CLAUDE JACKSONCredential: D.O.
Location Address410 E CHEROKEE STWagoner, OK 74467-4708
Mailing Address410 E Cherokee StWagoner, OK 74467-4708 · (918) 485-5591 · Fax (918) 485-5758
Phone(918) 485-5591
Fax(918) 485-5758
Sole ProprietorYes
Enumeration DateMarch 30, 2006
Last NPPES UpdateMarch 23, 20172 updates tracked since enumeration
✔ NPI 1669433546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OK · 1672
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
410 E CHEROKEE ST, Wagoner, OK 74467
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Other Names 1

Other Name (5)Michael Douglas Gorman M.d.

Other Identifiers 3

Medicaid100141080EOK
Medicaid100141080COK
Medicare NSC0818240001OK

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John Claude Jackson D.o. 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 74467 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
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
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 2

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

JACKSON MEDICAL CLINIC, PC
General Practice
410 E CHEROKEE ST
WAGONER, OK 74467
Wagoner County (918) 485-5591
DR. MICHAEL DOUGLAS GORMAN MD
Family Medicine
410 E CHEROKEE ST
WAGONER, OK 74467
Wagoner County (918) 485-5591

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 John Jackson's NPI number?

The NPI number for John Jackson is 1669433546. It was assigned to this individual provider in the NPPES registry on March 30, 2006. The provider is also known as Michael Douglas Gorman M.D..

Where is John Jackson located?

John Jackson practices at 410 E Cherokee St, Wagoner, OK 74467. The listed phone number is (918) 485-5591.

What is John Jackson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is John Jackson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for John Jackson was last updated on March 23, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.