James D Jackson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

30485 Issued in GA

Practice address

1285 Sims St
Gainesville, GA 30501-3851

Phone

(770) 219-8583

NPI assigned

May 23, 2005

Last updated

Mar 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjackson29354@nghs.gadirect.net

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.

• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212

  Internal Medicine

  Medicare reassignment NPD
• Gwinnett Dermatology PC D/B/a Georgia Dermatology Partners

  • Dermatology Physician
  • Snellville, GA
  • NPI 1477596203
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1003819111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 SIMS ST",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013851",
            "telephone_number": "770-219-8583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5875 Thompson Mill Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Hoschton",
            "state": "GA",
            "postal_code": "305484001",
            "country_code": "US",
            "telephone_number": "770-848-6140",
            "fax_number": "770-848-6141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JAMES",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "30485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00401783A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjackson29354@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1285 Sims St",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexandra Elizabeth Izaguirre, DMD
• J Andrew Ramsey DMD PC
• J Parks Medical LLC
• Ashley Valentine Jackson, FNP-C
• Gregory Dennis Jackson, MD
• Jeanine M. Jackson, CNNP
• Joseph Loy Jackson, D.M.D.
• Julie Stephens Jackson, AU.D.
• Kierney Elizabeth Jackson, PA
• Randy H Jackson, PA

• Internal Medicine Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.