Ancelle Mae Jackson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN300851 Issued in GA

Practice address

774 Highway 96
Bonaire, GA 31005-3300

Phone

(478) 988-5711

NPI assigned

Jan 14, 2019

Last updated

Oct 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allcare Ga PCGroup PAC ID 2668907940, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ancelle.jackson.1@33029.direct.athenahealth.com

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.

• Allcare Ga PC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1972080554
  Medicare reassignment Care Compare group NPD
• Conscious Regenerative Medicine LLC

  • Clinic/Center
  • Alpharetta, GA
  • NPI 1154213353
  Medicare reassignment NPD
• TLC of Georgia LLC

  dba The Little Clinic

  • Family Nurse Practitioner
  • Jefferson, GA
  • NPI 1750677241
  NPD
• MD Health Solutions

  dba Palmetto Infusion Services

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1588352769
  NPD (past)
• Capital Healthcare PC

  • Primary Care Clinic/Center
  • Alexandria, VA
  • NPI 1811239627
  NPD (past)

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1477027373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 RIDGE BROOK TRL",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300966810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 HIGHWAY 96",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310053300",
            "telephone_number": "478-988-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANCELLE MAE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-14",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11000926",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN300851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi E Hooper, LNMT
• Houston Case Management
• Houston Hospitals Inc
• Houston Hospitals Inc
• Clayton Hunt, LCSW
• Christopher L Jackson, D.C.
• Shalada Jackson
• Debra Eunette Johnson, M.ED, CCC-SLP
• Laquita Charle Johnson, NP
• Kristi Tucker Jones, NP-C

• Family Nurse Practitioner in Bonaire, GA
• Providers in Bonaire, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.
• 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.