Tracie Moore Jackson, M.ED., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP005090 Issued in GA

Practice address

3740 Melody Mizer LN
Cumming, GA 30041-6940

Phone

(770) 888-1222

NPI assigned

Nov 5, 2026

Last updated

Nov 5, 2026By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1793836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793836800000",
    "number": "1275432171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 DAHLONEGA HWY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300404536",
            "telephone_number": "770-887-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 MELODY MIZER LN",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416940",
            "telephone_number": "770-888-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TRACIE",
        "middle_name": "MOORE",
        "name_prefix": "Mrs.",
        "credential": "M.ED., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-11-05",
        "last_updated": "2026-11-05",
        "certification_date": "2026-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celeste Jackson
• Chandler Jackson, OTR/L
• Chevis M Jackson
• Jeffrey S Jackson, COTA
• Sage Matthew Jackson, M.A. CCC-SLP
• Tracy Ann Jackson, M.S., CCC-SLP
• Bobby Jacob, PHARM.D.
• Natalie Jacobson, PT, DPT
• Uma Jamched, MD
• James Fred Boling, M.D.

• Speech-Language Pathologist in Cumming, GA
• Providers in Cumming, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.