Sunny Michele Jackson

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN-NP268768 Issued in GA

Practice address

2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117

Phone

(404) 785-4747

NPI assigned

Jan 17, 2025

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

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 and National Provider Directory roles.

• Choa Hospital Based, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1457695488
  Medicare reassignment NPD
• Choa Multispecialty, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1437493467
  NPD

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1336950484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293117",
            "telephone_number": "404-785-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SUNNY",
        "middle_name": "MICHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "APRN-NP268768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Theron Jackson
• Samuel Lee Jackson
• Shamika Jackson, RN
• Stefanie Charisse Jackson, LMFT
• Stephane Lea Jackson, LMT, CCT
• Taneisha Chree Jackson
• Tanjela M Jackson, MD
• Tanya Tamara Jackson, APRN
• Tara Jackson, M.ED.
• Taylor Jackson, DC

• Pediatric Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; 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.