Active NPI
Jackson Urological Associates, P.C.
- Urology Physician
- Jackson, TN
National Provider Identifier
1770566986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- JACKSON UROLOGICAL ASSOCIATES, P.C.
- Practice address
- 28 Medical Center Dr
Jackson, TN 38301-3947 - Phone
- (731) 427-9971
- Fax
- (731) 424-2052
- NPI assigned
- Nov 22, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Whitney Tucker
- Title
- Office Manager
- Phone
- (731) 427-9971
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
28 Medical Center Dr
Jackson, TN 38301-3947
Mailing address
28 Medical Center Dr
Jackson, TN 38301-3947
Phone (731) 427-9971
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0142333 | Other | TN | BLUE CROSS BLUE SHIELD |
| 3704374 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040612000367 | TN | Part B Supplier - Clinic/Group Practice | 5395728935 |
Receives reassigned benefits from 6 practitioners Practice locations: Jackson, TN |
National Provider Directory
National Provider DirectoryLocations
28 Medical Center Dr
Jackson, TN 38301
Phone (731) 427-9971
207 Stonebridge Blvd
Jackson, TN 38305
Phone (731) 661-6340
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Jackson, TN
- NPI 1871055632
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1774396800000",
"number": "1770566986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 MEDICAL CENTER DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013947",
"telephone_number": "731-427-9971",
"fax_number": "731-427-9973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 MEDICAL CENTER DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013947",
"telephone_number": "731-427-9971",
"fax_number": "731-424-2052"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JACKSON UROLOGICAL ASSOCIATES, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-22",
"last_updated": "2026-03-25",
"certification_date": "2026-03-25",
"status": "A",
"authorized_official_last_name": "TUCKER",
"authorized_official_first_name": "WHITNEY",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "731-427-9971",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0142333",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3704374",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, TN
- Jackson Senior Services, LLC
- Jackson Spa LLC
- Jackson Surgical Associates. PA
- Jackson Tennessee Hospital Company LLC
- Jackson Transit Authority
- Jackson Weight Management, Inc.
- Jackson-Madison County Gen Hospital
- Jackson-Madison County General Hospital
- Jackson-Madison County General Hospital
- Jackson-Madison County General Hospital
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.