Active NPI
Jimmie K Jackson, MD
- Surgery Physician
- Oklahoma City, OK
National Provider Identifier
1891761599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 8567
- Practice address
- 1237 Glenbrook Dr
Oklahoma City, OK 73118-1021 - Phone
- (405) 659-7578
- Fax
- (405) 232-3767
- NPI assigned
- Feb 23, 2006
- Last updated
- Sep 29, 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 8567 | OK | Primary |
Addresses
Primary practice location
1237 Glenbrook Dr
Oklahoma City, OK 73118-1021
Mailing address
1237 Glenbrook Dr
Oklahoma City, OK 73118-1021
Phone (405) 659-7578
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100087430A | Medicaid | OK |
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)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norman Regional Providers Primary Care | Past | Accepting new patients | |
| Surgical Specialists of Oklahoma PLLC | Surgery | Past | Accepting new patients |
| Surgical Specialists of Oklahoma | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Norman, OK
- NPI 1548398274
-
- Durable Medical Equipment & Medical Supplies
- Midwest City, OK
- NPI 1154636595
-
- Surgery Physician
- Midwest City, OK
- NPI 1871542639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790640000000",
"number": "1891761599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1237 GLENBROOK DR",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731181021",
"telephone_number": "405-659-7578",
"fax_number": "405-232-3767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1237 GLENBROOK DR",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731181021",
"telephone_number": "405-659-7578",
"fax_number": "405-232-3767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JIMMIE",
"middle_name": "K",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-23",
"last_updated": "2026-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OK",
"license": "8567",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100087430A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.