Carmen Yolanda Jackson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN149316 Issued in GA

Practice address

1900 Tebeau St
Waycross, GA 31501-6357

Phone

(912) 287-2555

NPI assigned

Jul 11, 2017

Sex

Female

Sole proprietor

No

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.

• Unison Behavioral Health

  • Community/Behavioral Health Agency
  • Waycross, GA
  • NPI 1528104866

  GA

  Medicare reassignment Care Compare group NPD
• Peter Wrobel MD PC

  • Family Medicine Physician
  • Waycross, GA
  • NPI 1063654929

  GA

  Medicare reassignment NPD
• Unison Behavioral Health

  • Counselor
  • Homerville, GA
  • NPI 1427368539
  NPD

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Unison Behavioral Health 19 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.2 of 100Reported as group

Quality

100

Promoting interoperability

98

Improvement activities

40

Cost

83.13

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306368329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 TEBEAU ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016357",
            "telephone_number": "912-287-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 TEBEAU ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016357",
            "telephone_number": "912-287-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CARMEN",
        "middle_name": "YOLANDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN149316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Internal Medicine Associates of Waycross, P.C.
• Ahmad Irfan, M.D.
• Iveta Berzinch MD PC
• J H Harvey Co LLC
• Jackson Family Dentistry PC
• Maria Shauntee Jackson
• Jacobs Clinic, Inc.
• Hamley Jacobs
• John Franklin Jacobs, PHYSICIAN ASSISTANT
• Robert Scott Jacobs, NP

• All providers in Waycross, GA
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.