Jonathan D Jackson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN162421 Issued in GA

Practice address

25 Tranquil LN
Ringgold, GA 30736-2859

Phone

(423) 902-9979

Fax

(423) 373-1228

NPI assigned

Aug 2, 2022

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

Medicare fee-for-service enrollment

Enrolled in GA, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gordon Emergency Physicians, LLCGroup PAC ID 6406149400, 22 clinicians

DX Mso of Georgia LLCGroup PAC ID 1153702931, 9 clinicians

DX Mso PLLCGroup PAC ID 7719131101, 88 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• DX Mso of Georgia LLC

  • Multi-Specialty Clinic/Center
  • Dalton, GA
  • NPI 1922757111
  Medicare reassignment Care Compare group NPD
• Gordon Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Calhoun, GA
  • NPI 1205290467
  Medicare reassignment Care Compare group NPD
• DX Mso, PLLC

  • Urgent Care Clinic/Center
  • Chattanooga, TN
  • NPI 1225381148
  Medicare reassignment Care Compare group NPD
• Hamilton Medical Center, Inc.

  • General Acute Care Hospital
  • Dalton, GA
  • NPI 1528056066
  Medicare reassignment NPD
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593

  GA

  Medicare reassignment NPD
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  GA

  Medicare reassignment NPD
• Emergency Medicine Services of TN, PC

  • Emergency Medicine Physician
  • Nashville, TN
  • NPI 1720785884

  Family

  Medicare reassignment NPD
• Gordon Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Chatsworth, GA
  • NPI 1639621485
  NPD
• Hamilton Physician Group Inc

  • Cardiovascular Disease Physician
  • Dalton, GA
  • NPI 1235455569
  NPD
• Afc Urgent Care and Family Care of WNC, PLLC

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1679066658
  NPD (past)
• Parkridge Medical Center, Inc.

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1104874684
  NPD (past)

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1104553924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 TRANQUIL LN",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307362859",
            "telephone_number": "423-902-9979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 TRANQUIL LN",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307362859",
            "telephone_number": "423-902-9979",
            "fax_number": "423-373-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN162421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independent Physical Therapy of Ga LLC
• Interventional Pain Consultants
• Ireland Health Services
• Elyssa Lauren Jacks, DMD
• William Thomas Jacks, DMD
• Timothy Jackson
• Shoba Jacob
• Kristen Rae Jaster
• Alexis Jenkins
• Troy Jensen

• Family Nurse Practitioner in Ringgold, GA
• Providers in Ringgold, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.