Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Scotty Jackson, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1750095980

Scotty Jackson, FNP-BC is a Nurse Practitioner in Pauls Valley, Oklahoma. Qualified in 2022, 4 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
4
Licensed in
OK
In the registry since
2023
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

34550 Airline Rd
Pauls Valley, OK 73075-9337
Phone: (405) 207-9238
Fax: (405) 207-9240
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 211329 (OK)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence R0078720 (OK)

Record details

NPI number1750095980
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-BC
Sole proprietorYes
NPI enumeratedJanuary 11, 2023
Last updated in NPPESJuly 11, 2023
Certification dateJuly 11, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Pauls Valley