Kristy H Jackson MD PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

060643 Issued in GA

Legal business name

KRISTY H JACKSON MD PC

Practice address

920 Dannon VW SW
Ste 3104
Atlanta, GA 30331-2157

Phone

(404) 629-3933

Fax

(404) 629-3935

NPI assigned

Jul 21, 2014

Organization subpart

No

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

Authorized official

Name

Kristy H Jackson, MDNPI 1043484645

Title

Ceo

Phone

(404) 629-3933

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristy Hendricks Jackson, M.D.

  • Psychiatry Physician
  • Marietta, GA
  • NPI 1043484645
  NPD Authorized official

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1184031320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 441",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302130441",
            "telephone_number": "404-629-3933",
            "fax_number": "404-629-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 DANNON VW SW",
            "address_2": "STE 3104",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312157",
            "telephone_number": "404-629-3933",
            "fax_number": "404-629-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTY H JACKSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-629-3933",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "060643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Kriske, AGACNP
• Taylor Kristan
• Kristen Albritton, LLC
• Kieran Allen Kristensen, MD
• Tyler Joseph Kristoff
• Randall W Krizan, AA
• Julie Berryman Krochonis, NP
• Andrew Cameron Kroh, M.D.
• Benjamin Sydney Krohn, AA-C
• Edward Gerard Krolikowski, D.C.

• Psychiatry Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.