James W Jackson Jr., MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

034372 Issued in GA

Practice address

450 Georgia Ave
Ste B
Statesboro, GA 30458

Phone

(912) 489-4123

Fax

(912) 764-4977

NPI assigned

Oct 3, 2006

Last updated

Oct 9, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 14

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

Nephrology

Education

Louisiana State University School of Medicine in New Orleans, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fresenius Medical Care of Bulloch County Dialysis facility, Statesboro, GA, CCN 112766
• Fresenius Medical Care of Toombs County Dialysis facility, Vidalia, GA, CCN 112768
• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075
• Memorial Health Meadows Hospital Hospital, Vidalia, GA, CCN 110128
• Evans Memorial Hospital Hospital, Claxton, GA, CCN 110142
• Emanuel Medical Center Hospital, Swainsboro, GA, CCN 110109
• Jeff Davis Hospital Hospital, Hazlehurst, GA, CCN 111333

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.

• East Georgia Nephrology, PC

  • Nephrology Physician
  • Statesboro, GA
  • NPI 1215128186
  Medicare reassignment NPD Authorized official
• Hospital Authority of Candler County

  dba Candler County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Metter, GA
  • NPI 1588868947
  Medicare reassignment NPD
• Hospital Authority of Candler County

  dba Pulaski Health & Wellness

  • Primary Care Clinic/Center
  • Pulaski, GA
  • NPI 1316523707
  NPD
• Hospital Authority of Candler County

  dba Candler County Hospital

  • Critical Access Hospital
  • Metter, GA
  • NPI 1790888089
  NPD

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

• Bio-Medical Applications of Georgia, Inc.

  dba Fresenius Medical Care of Toombs County

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Vidalia, GA
  • NPI 1336193192

  Dialysis facility

  Care Compare affiliation Name & address match
• Bio-Medical Applications of Georgia, Inc.

  dba Fresenius Medical Care of Bulloch County

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Statesboro, GA
  • NPI 1497707657

  Dialysis facility

  Care Compare affiliation Name & address match
• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation
• Emanuel County Hospital Authority

  dba Emanuel Medical Center

  • Rural Acute Care Hospital
  • Swainsboro, GA
  • NPI 1235129214
  Care Compare affiliation
• Evans Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Claxton, GA
  • NPI 1730110826
  Care Compare affiliation
• Hospital Authority of Jeff Davis County Georgia

  dba Jeff Davis Hospital

  • Critical Access Hospital
  • Hazlehurst, GA
  • NPI 1912902263
  Care Compare affiliation
• Vidalia Health Services, LLC

  • General Acute Care Hospital
  • Vidalia, GA
  • NPI 1790376564
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1467547836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 GEORGIA AVE",
            "address_2": "STE B",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-489-4123",
            "fax_number": "912-764-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 GEORGIA AVE",
            "address_2": "STE B",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-489-4123",
            "fax_number": "912-764-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JAMES",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "034372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569687F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569687D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569687T",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "366237",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390006768",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569687Q",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569687R",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569687V",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569687X",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569687E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569687G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10063368",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569687H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000569687S",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Internal Medicine Associates of Statesboro II, PC
• Intune, LLC (InTune Counseling)
• Kristen Leigh Ivey, FNP
• J H Harvey Co LLC (Harveys Supermarket Pharmacy)
• Allison Jackson
• Tawanna Jackson
• Alan Jacobs
• Ajay Jain, MD
• James L. Hiller, MD, PC
• Jenny R Janney, PA-C

• Nephrology Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.