Active NPI
John S Jackson, M.D.
- Gastroenterology Physician
- Fort Worth, TX
National Provider Identifier
1437140779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- E1626
- Practice address
- 6445 Harris Pkwy
Ste. 100
Fort Worth, TX 76132-4138 - Phone
- (817) 361-6900
- Fax
- (817) 263-2918
- NPI assigned
- Nov 4, 2005
- 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | E1626 | TX | Primary |
Addresses
Primary practice location
6445 Harris Pkwy
Ste. 100
Fort Worth, TX 76132-4138
Mailing address
6445 Harris Pkwy
Ste. 100
Fort Worth, TX 76132-4138
Phone (817) 361-6900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85Y011 | Other | BCBS | |
| 4035105 | Other | AETNA |
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 |
|---|---|---|---|
| Patheous Medical PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1437140779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6445 HARRIS PKWY",
"address_2": "STE. 100",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761324138",
"telephone_number": "817-361-6900",
"fax_number": "817-263-2918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6445 HARRIS PKWY",
"address_2": "STE. 100",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761324138",
"telephone_number": "817-361-6900",
"fax_number": "817-263-2918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JOHN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-04",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "TX",
"license": "E1626",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "85Y011",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4035105",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
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.