Harold Damon Jackson, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

032591 Issued in GA

Practice address

2665 N Decatur Rd
Suite 430
Decatur, GA 30033-6149

Phone

(404) 294-4018

Fax

(404) 294-1359

NPI assigned

Dec 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

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

Specialty

Pulmonary DiseaseAlso: Critical Care (Intensivists)

Education

Medical University of South Carolina College of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Georgia Pulmonary Associates, LLCGroup PAC ID 0648266015, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Longleaf Hospice, LLC Hospice, Atlanta, GA, CCN 111680
• St Marys Good Samaritan Hospital Hospital, Greensboro, GA, CCN 111329
• Navicent Health Baldwin Hospital, Milledgeville, GA, CCN 110150
• Putnam General Hospital Hospital, Eatonton, GA, CCN 111313
• Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091
• Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JAGGAA

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.

• Central Georgia Pulmonary Associates, LLC

  • Pulmonary Disease Physician
  • Macon, GA
  • NPI 1669521902
  Medicare reassignment Care Compare group NPD
• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  NPD

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

• Longleaf Hospice, LLC

  • Community Based Hospice Care Agency
  • Atlanta, GA
  • NPI 1427206960
  Care Compare affiliation
• Navicent Health Baldwin, Inc

  • General Acute Care Hospital
  • Milledgeville, GA
  • NPI 1841701562
  Care Compare affiliation
• Piedmont Newton Hospital, Inc.

  • General Acute Care Hospital
  • Covington, GA
  • NPI 1760498588
  Care Compare affiliation
• Piedmont Rockdale Hospital Inc.

  • General Acute Care Hospital
  • Conyers, GA
  • NPI 1306355680
  Care Compare affiliation
• Putnam General Hospital Authority

  • Critical Access Hospital
  • Eatonton, GA
  • NPI 1386670834
  Care Compare affiliation
• St. Mary'S Good Samaritan Hospital, Inc.

  • Critical Access Hospital
  • Greensboro, GA
  • NPI 1346209137
  Care Compare affiliation

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1164406252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 N DECATUR RD",
            "address_2": "SUITE 430",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336149",
            "telephone_number": "404-294-4018",
            "fax_number": "404-294-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 N DECATUR RD",
            "address_2": "SUITE 430",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336149",
            "telephone_number": "404-294-4018",
            "fax_number": "404-294-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HAROLD",
        "middle_name": "DAMON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "032591",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "032591",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1164406252",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00421363D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4365944",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110089544",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4806794",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "5931",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "0932200001",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "479614",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6613810008",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2598499",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Nicole Jackson
• Dewanda B. Jackson, LPC, CPCS, EAU-C
• Donna Michelle Jackson
• Emily Brockett Jackson, PHD
• Felicia Lynette Jackson, PHD
• Hazel Anita Jackson, MN, RN, APRN,BC
• Joy Jackson
• Kia Maria Jackson, COTA
• Latoya Jackson, LCSW
• Richard Jackson Jr.

• Pulmonary Disease Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Pulmonary Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.