David Ray Jackson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN154383 Issued in GA

Practice address

2301 N Ashley St
Valdosta, GA 31602-2620

Phone

(229) 270-2403

Fax

(229) 468-0688

NPI assigned

Feb 12, 2007

Last updated

Jul 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SGMC Affiliated Services LLCGroup PAC ID 5496284028, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.jackson@tnc.directbygreenway.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SGMC Affiliated Services LLC

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1114740362
  Medicare reassignment Care Compare group NPD
• Care Medical Center LLC

  • Exclusive Provider Organization
  • Valdosta, GA
  • NPI 1063521250
  Medicare reassignment NPD
• North Oak Family Medicine LLC

  • Internal Medicine Physician
  • Valdosta, GA
  • NPI 1417668021
  Medicare reassignment NPD
• South Central Primary Care Center, Inc

  dba South Central Primary Care- Ashley Street

  • Federally Qualified Health Center (FQHC)
  • Valdosta, GA
  • NPI 1467223818
  Medicare reassignment NPD
• South Georgia Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • Thomasville, GA
  • NPI 1386903649
  Medicare reassignment NPD
• Care Medical Center LLC

  • Chiropractor
  • Waycross, GA
  • NPI 1376236232
  NPD
• Emergency Medicine South LLC

  • Emergency Medicine Physician
  • Valdosta, GA
  • NPI 1194785170
  NPD (past)
• Radiology Associates of Valdosta, P.C.

  • Diagnostic Radiology Physician
  • Valdosta, GA
  • NPI 1205888708
  NPD (past)
• South Central Primary Care Center, Inc

  dba South Central Family Medicine

  • Federally Qualified Health Center (FQHC)
  • Pearson, GA
  • NPI 1558445742
  NPD (past)

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

• South Georgia Medical Center Inc

  dba SGMC Health

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553
  Care Compare affiliation

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1215079983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E 4TH ST",
            "city": "OCILLA",
            "state": "GA",
            "postal_code": "317741539",
            "telephone_number": "229-468-9166",
            "fax_number": "229-468-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N ASHLEY ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022620",
            "telephone_number": "229-270-2403",
            "fax_number": "229-468-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DAVID",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN154383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• It's Just Blood Diagnostic Testing Center LLC
• Itransport Angels
• J H Harvey Co LLC (Harveys Supermarket Pharmacy #2309)
• J H Harvey Co LLC (Harveys Supermarket Pharmacy #2310)
• Courtney Tamara Jackson, NP
• Dorothy L Jackson
• Ginger D Jackson, PTA
• Jermika L Jackson, RBT
• Sarah L. Jackson, RD., LDN.
• Shetia Donyette Jackson, BSW

• Family Nurse Practitioner in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.