Active NPI
Richard Jackson, MD
- Anesthesiology Physician
- Greenville, MS
National Provider Identifier
1215994231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 17867
- Practice address
- 1400 E Union St
Greenville, MS 38703-3246 - Phone
- (662) 378-3783
- NPI assigned
- Apr 26, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 17867 | MS | Primary |
Addresses
Primary practice location
1400 E Union St
Greenville, MS 38703-3246
Mailing address
PO Box 235019
Montgomery, AL 36123-5019
Phone (334) 279-1450
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06289024 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delta Physician Practices | Past | Accepting new patients | |
| Delta Medical Group | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Greenville, MS
- NPI 1790701134
-
- Family Nurse Practitioner
- Greenville, MS
- NPI 1598086639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1215994231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 235019",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361235019",
"telephone_number": "334-279-1450",
"fax_number": "334-279-1660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E UNION ST",
"city": "GREENVILLE",
"state": "MS",
"postal_code": "387033246",
"telephone_number": "662-378-3783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MS",
"license": "17867",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06289024",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, MS
Sources for this page
- 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.