Billie Luke Jackson, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

30791 Issued in GA

Practice address

440 Charter Blvd
Suite 2201
Macon, GA 31210-4857

Phone

(478) 477-5575

Fax

(478) 477-0707

NPI assigned

Sep 6, 2006

Last updated

Nov 3, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Dermatology

Education

Medical College of Georgia School of Medicine, 1984

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Billie L. Jackson, M.D., LLC

  • Dermatology Physician
  • Macon, GA
  • NPI 1114296464
  Medicare reassignment NPD Authorized official

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

• The Medical Center of Central Georgia Inc

  dba Atrium Health Navicent The Medical Center

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1043270564
  Care Compare affiliation

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1235232430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 CHARTER BLVD",
            "address_2": "SUITE 2201",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104857",
            "telephone_number": "478-477-5575",
            "fax_number": "478-477-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 CHARTER BLVD",
            "address_2": "SUITE 2201",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104857",
            "telephone_number": "478-477-5575",
            "fax_number": "478-477-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BILLIE",
        "middle_name": "LUKE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "30791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000373513E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J Gregory Jones MD PC
• J.Bryan, Inc (Scott's Pharmacy # 2)
• J.H. Harvey Co., LLC (Harveys Supermarket Pharmacy #2405)
• Jackson Lake Hospice Inc (Jackson Lake Hospice)
• Aisha Jackson
• Ellis R Jackson, CRNA
• Ida Desiree Jackson
• Krisa Forehand Jackson, ATC, PA-C
• Leonia Jackson
• Melvin Jackson, MD

• Dermatology Physician in Macon, GA
• Providers in Macon, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.