Active NPI
Lana Jean Jackson, P.A.
- Physician Assistant
- Atlanta, GA
National Provider Identifier
1174570444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 003091
- Practice address
- 5670 Peachtree Dunwoody Rd NE
Suite 1000
Atlanta, GA 30342-1704 - Phone
- (404) 255-1930
- Fax
- (404) 459-8510
- NPI assigned
- May 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 003091 | GA | Primary |
Addresses
Primary practice location
5670 Peachtree Dunwoody Rd NE
Suite 1000
Atlanta, GA 30342-1704
Mailing address
5670 Peachtree Dunwoody Rd NE
Suite 1000
Atlanta, GA 30342-1704
Phone (404) 255-1930
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003091 | GA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Cardiovascular Medicine, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Marietta, GA
- NPI 1457320319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1174570444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5670 PEACHTREE DUNWOODY RD NE",
"address_2": "SUITE 1000",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421704",
"telephone_number": "404-255-1930",
"fax_number": "404-459-8510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5670 PEACHTREE DUNWOODY RD NE",
"address_2": "SUITE 1000",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421704",
"telephone_number": "404-255-1930",
"fax_number": "404-459-8510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "LANA",
"middle_name": "JEAN",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-30",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "003091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.