Geraldine Jackson

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

GERALDINE JACKSON

Practice address

149 N Park TRL
Stockbridge, GA 30281-7373

Phone

(770) 947-3967

Fax

(678) 369-7392

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Geraldine Jackson

Title

President

Phone

(770) 947-3967

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1154422160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 N PARK TRL",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817373",
            "telephone_number": "770-947-3967",
            "fax_number": "678-369-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 N PARK TRL",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817373",
            "telephone_number": "770-947-3967",
            "fax_number": "678-369-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALDINE JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GERALDINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-947-3967"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgia Pain and Wellness Center
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• Georgia South Hand Therapy, Inc
• Georgia Urology PA
• Rodarline Gerard, CRNA
• Get Better PT LLC
• Daniel Jacob Gianoli, MD
• Gideon Chiropractic Incorporated
• Mindy Sungmin Gil, DMD, DMSC

• Customized Equipment (DME) in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Customized Equipment (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.