Timothy James Jackson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN 073450 Issued in LA

Practice address

155 Hospital Dr
Lafayette, LA 70503-2852

Phone

(337) 269-9777

Fax

(337) 269-0244

NPI assigned

Oct 6, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cardiology Centre of Lafayette

  • Clinic/Center
  • Lafayette, LA
  • NPI 1871571042
  NPD (past)
• Kenneth D Futch, MD, AMC

  • Cardiovascular Disease Physician
  • Lafayette, LA
  • NPI 1336299056
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1144217969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52507",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052507",
            "telephone_number": "337-269-9777",
            "fax_number": "337-269-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 HOSPITAL DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032852",
            "telephone_number": "337-269-9777",
            "fax_number": "337-269-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN 073450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1949388",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Micaela Shanta Jackson
• Natasha Jackson
• Nia Angaline Jackson
• Reginald D Jackson
• Shanel S. Jackson, M.A.
• Valerie Perrault Jackson, FNP
• Jacob Dent, DDS Lafayette Modern Dentistry, a Professional Corporation
• Jacob L Breaux, MD, LLC
• Jacob R Karr, MD, LLC
• Jerome Jacob Jr.

• Nurse Practitioner in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.