Individual provider Active NPI

Reginald Roberts Jackson, M.D.

  • Hospitalist Physician
  • Atlanta, GA
National Provider Identifier
1154427615
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
051007 Issued in GA
Practice address
35 Collier Rd NW
Suite 635
Atlanta, GA 30309
Phone
(404) 367-3014
Fax
(404) 367-3558
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 051007 GA
Hospitalist Physician 208M00000X 051007 GA Primary

Addresses

Primary practice location

35 Collier Rd NW
Suite 635
Atlanta, GA 30309

Mailing address

PO Box 102321
Atlanta, GA 30368
Phone (404) 367-3014

Other identifiers 1

IdentifierTypeStateIssuer
00932896AMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040623000137 GA Practitioner - Internal MedicinePractitioner - Hospitalist 7416932645 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Medical College of Georgia School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
051007GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Hospitalists Group, LLC Hospitalist CurrentSince Jan 25, 2016 Accepting new patients
The Emory Clinic Inc Internal Medicine CurrentSince Jan 7, 2024 Accepting new patients
Southern Regional Physicians Management Group, LLC CurrentSince Feb 20, 2017 Accepting new patients
City of Hope Medical Group of Georgia LLC Internal Medicine CurrentSince Jul 29, 2023 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Nov 5, 2015 Accepting new patients
Georgia Hospitalists Group, LLC Hospitalist CurrentSince Jan 25, 2016 Accepting new patients
Crawford Long Hospital Past Accepting new patients

Locations

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2360 Rockmart Hwy
Cedartown, GA 30125
Phone (770) 748-2500

1170 Cleveland Ave
Fl 4
East Point, GA 30344
Phone (404) 466-6273

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

11 Upper Riverdale Rd SW
Ste 21
Riverdale, GA 30274

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

62742 Collections Ctr Dr
Chicago, IL 60693

Interoperability endpoints

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

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1154427615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102321",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30368",
            "telephone_number": "404-367-3014",
            "fax_number": "404-367-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 COLLIER RD NW",
            "address_2": "SUITE 635",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309",
            "telephone_number": "404-367-3014",
            "fax_number": "404-367-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "REGINALD",
        "middle_name": "ROBERTS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "051007",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "051007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00932896A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.