NPIMap

Organization Active NPI

Jackson Eye Associates PLLC

  • Ophthalmology Physician
  • Madison, MS
National Provider Identifier
1164428868
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0506678 Issued in MS
Legal business name
JACKSON EYE ASSOCIATES PLLC
Practice address
1026 Baptist Cir Ste 100
Madison, MS 39110-2033
Phone
(601) 353-2020
Fax
(601) 352-5988
NPI assigned
Jun 27, 2005
Organization subpart
Yes
Parent organization
JACKSON EYE ASSOCIATES PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Authorized official

Name
Benjamin M Higginbotham
Title
Ao
Phone
(601) 353-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 0506678 MS Primary

Addresses

Primary practice location

1026 Baptist Cir Ste 100
Madison, MS 39110-2033

Mailing address

1026 Baptist Cir Ste 100
Madison, MS 39110-2033
Phone (601) 353-2020

Other identifiers 2

IdentifierTypeStateIssuer
03189030MedicaidMS
529921670MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040308000859 MS Part B Supplier - Clinic/Group Practice 2264320662 Receives reassigned benefits from 13 practitioners
Practice locations: Madison, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
V John Ford III MD2 organizations share this tax ID, including this one
Part of
V John Ford III MD

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

102 Clinton Pkwy
Fl 3
Clinton, MS 39056
Phone (601) 353-2020

103 Millsaps Dr
Hattiesburg, MS 39402
Phone (601) 268-5910

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/t7g8d1e4

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778803200000",
    "number": "1164428868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 BAPTIST CIR STE 100",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102033",
            "telephone_number": "601-353-2020",
            "fax_number": "601-352-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 BAPTIST CIR STE 100",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102033",
            "telephone_number": "601-353-2020",
            "fax_number": "601-352-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON EYE ASSOCIATES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON EYE ASSOCIATES PLLC",
        "enumeration_date": "2005-06-27",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A",
        "authorized_official_last_name": "HIGGINBOTHAM",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "601-353-2020"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "0506678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03189030",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529921670",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.