Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Randall Jackson, CFNP

Individual provider Family Nurse Practitioner · NPI 1144614165

Randall Jackson, CFNP is a Nurse Practitioner in McComb, Mississippi. Qualified in 2015, 11 years ago. Practices with Southwest Mississippi Regional Medical Center, a 84-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
11
Licensed in
MS
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

215 Marion Ave
McComb, MS 39648-2705
Phone: (601) 249-5500
Fax: (601) 249-1173
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 878547 (MS)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence R878547 (MS)

Record details

NPI number1144614165
Entity typeIndividual (Type 1)
GenderMale
Credentials CFNP
Sole proprietorNo
NPI enumeratedMarch 27, 2015
Last updated in NPPESMay 2, 2022
Certification dateMay 2, 2022
Mailing addressPo Box 490, McComb, MS 39649-0490

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Southwest Mississippi Regional Medical Center — 84 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in McComb