Annanta Jackman

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7696 Issued in GA

Practice address

4200 Northside Pkwy NW BLDG 8
Atlanta, GA 30327-3007

Phone

(404) 881-8020

NPI assigned

Aug 19, 2016

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Georgia Mso LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1952196164
  Medicare reassignment NPD
• Cogent Healthcare of Georgia PC

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1609827823
  Medicare reassignment
• Hardy Renew Wellness,LLC

  • Internal Medicine Physician
  • Marietta, GA
  • NPI 1952914368
  Medicare reassignment
• Medical Director Services PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Princess Anne, MD
  • NPI 1871955807

  GA

  Medicare reassignment

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1306391313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 NORTHSIDE PKWY NW BLDG 8",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303273007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 NORTHSIDE PKWY NW BLDG 8",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303273007",
            "telephone_number": "404-881-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKMAN",
        "first_name": "ANNANTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wissam A Jaber, M.D.
• Wissam S Jaber, MD
• Leva Jaberizadeh
• Wendy Jacek, FNP-C
• Loolo Grace Jack
• Summer N. Jackman, SLP
• Devon Nobis Jackoniski, PA
• Anabella Jacks, MD
• Sherri Jacks, LPC
• Jackson EMS

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.