Timothy Jackson, MD, SA-C
Timothy Jackson, MD, SA-C is a Surgical Assistant in Gulfport, MS, registered under NPI 1093710089. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 4500 13TH ST, Gulfport, MS 39501. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 19-516 | Surgical Assistant primary | |
| 14510 | MS | Orthopaedic Surgery Physician |
This provider holds licence 19-516 issued in MS. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Surgical Assistant covers
A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. NUCC Health Care Provider Taxonomy, code 246ZC0007X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 246ZC0007X | Surgical Assistant Surgical Assistant | 19-516 | — | primary |
| 207X00000X | Orthopaedic Surgery Physician | 14510 | MS |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1093710089 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jun 16, 2005 |
| Last updated | Jan 14, 2026 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | MD, SA-C |
| Practice address |
4500 13TH ST Gulfport, MS 39501 (228) 304-9436 |
| Mailing address |
15520 DANIEL BLVD # 310 Gulfport, MS 39503 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 9 | 3 | 7 | 1 | 0 | 0 | 8 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 9 | 3 | 5 | 1 | 0 | 0 | 7 |
Sum = 51 · next multiple of 10 = 60 · check digit = 9 · actual last digit = 9
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.