Individual provider Active NPI

Jermaine M Jackson, MD

  • Pulmonary Disease Physician
  • Atlanta, GA
National Provider Identifier
1225214745
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
060278 Issued in GA
Practice address
2045 Peachtree Rd NE
Suite T-1
Atlanta, GA 30309-1414
Phone
(404) 350-0009
Fax
(404) 350-0280
NPI assigned
Jan 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 060278 GA Primary

Addresses

Primary practice location

2045 Peachtree Rd NE
Suite T-1
Atlanta, GA 30309-1414

Mailing address

2045 Peachtree Rd NE
Suite T-1
Atlanta, GA 30309-1414
Phone (404) 350-0009

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
I20080603000004 GA Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 0345226239 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
University of Tennessee, HSC, College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1968 Peachtree NW Rd
Atlanta, GA 30309-1281
Phone (404) 605-5000

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-5000

1968 Peachtree Rd NW Atlanta
77 Building Suite 3110
Atlanta, GA 30309-1281
Phone (770) 605-4224

1984 Peachtree Rd NW
Suite 300
Atlanta, GA 30309-5219
Phone (404) 367-3210

275 Collier Rd NW
Suite 300
Atlanta, GA 30309-1740
Phone (404) 350-0009

3820 Medical Park Dr
Austell, GA 30106-1110
Phone (770) 948-6041

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
060278GAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Specialty Hospital Billing LLC CurrentSince Apr 1, 2018 Accepting new patients
Piedmont Providers LLC CurrentSince May 1, 2013 Accepting new patients
Piedmont Healthcare Inc CurrentSince Dec 1, 2013 Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

2045 Peachtree Rd NE
Ste T1
Atlanta, GA 30309
Phone (404) 350-0009

1984 Peachtree Rd NW
Ste 205
Atlanta, GA 30309

275 Collier Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 350-0009

3820 Medical Park Dr
Austell, GA 30106
Phone (770) 948-5409

400 Tower Rd NE
Ste 200
Marietta, GA 30060
Phone (770) 514-7550

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 3

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": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1225214745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 PEACHTREE RD NE",
            "address_2": "SUITE T-1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091414",
            "telephone_number": "404-350-0009",
            "fax_number": "404-350-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 PEACHTREE RD NE",
            "address_2": "SUITE T-1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091414",
            "telephone_number": "404-350-0009",
            "fax_number": "404-350-0280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JERMAINE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-15",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "060278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.