Jordan Tyler Jackson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33753 Issued in MS

Practice address

1100 Highway 16 E
Carthage, MS 39051-4222

Phone

(601) 267-1470

Fax

(601) 267-1469

NPI assigned

May 4, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC, MS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Medical Center-Leake, Inc. 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of Carthage Home health agency, Carthage, MS, CCN 257129
• Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
• Quality Hospice Care, Inc Hospice, Philadelphia, MS, CCN 251580
• Baptist Medical Center-Leake Hospital, Carthage, MS, CCN 251315
• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102
• Baptist Medical Center-Leake Nursing home, CCN 25Z315

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Baptist Medical Center-Leake, Inc

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1356626618

  Family Medicine, MS

  Medicare reassignment Care Compare group NPD
• Self Medical Group

  • Surgery Physician
  • Greenwood, SC
  • NPI 1982836847

  SC

  Medicare reassignment NPD
• Baptist Medical Center-Leake, Inc

  • Rural Health Clinic/Center
  • Walnut Grove, MS
  • NPI 1649546342
  Care Compare group NPD
• Baptist Medical Center-Leake, Inc.

  • Rural Health Clinic/Center
  • Carthage, MS
  • NPI 1194861260
  Care Compare group NPD
• Baptist Medical Center-Leake Inc

  • Critical Access Hospital
  • Carthage, MS
  • NPI 1205112539
  Care Compare group NPD (past)
• Baptist Medical Center-Leake, Inc

  • Rural Health Clinic/Center
  • Walnut Grove, MS
  • NPI 1548310782
  Care Compare group NPD (past)
• Self Medical Group

  • Diagnostic Radiology Physician
  • Greenwood, SC
  • NPI 1659839694
  NPD
• Self Medical Group

  • Emergency Medicine Physician
  • Greenwood, SC
  • NPI 1740788165
  NPD
• BMC - Attala, LLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1023481595

  Family Medicine

  NPD (past)
• Medical Foundation of Central Mississippi, Inc.

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1992774814

  Family Medicine

  NPD (past)
• Self Medical Group

  • Gastroenterology Physician
  • Greenwood, SC
  • NPI 1841047560
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Medical Center-Leake Inc

  • Critical Access Hospital
  • Carthage, MS
  • NPI 1205112539

  Hospital

  Care Compare affiliation
• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585

  Hospital

  Care Compare affiliation
• Mississippi Homecare of Jackson II, LLC

  • Home Health Agency
  • Jackson, MS
  • NPI 1730373275
  Care Compare affiliation
• Quality Hospice Care, Inc

  • Community Based Hospice Care Agency
  • Philadelphia, MS
  • NPI 1902805161

  Hospice

  Care Compare affiliation
• Sta-Home Health Agency of Carthage, Inc

  • Home Health Agency
  • Carthage, MS
  • NPI 1275674533
  Care Compare affiliation

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1700469012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "telephone_number": "877-348-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HIGHWAY 16 E",
            "city": "CARTHAGE",
            "state": "MS",
            "postal_code": "390514222",
            "telephone_number": "601-267-1470",
            "fax_number": "601-267-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JORDAN",
        "middle_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-04",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "33753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjackson523247@selfregional.direct-ci.net",
            "affiliation": "N",
            "address_1": "155 Academy Ave",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296463869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hospice Providers, LLC
• Rosie Hutchins
• Infinity Hospice Care, Inc.
• Infinity Hospice, LLC
• Isd Renal Inc
• Amanda Jones Mitchell, CNA
• Anya Jones
• Tommy G. Jones, D.D.S., PLLC, D.D.S.
• Tommie K Jones, C.F.N.P.
• Janet Kelly

• All providers in Carthage, MS
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.