Jackie Maryline Bassong, FNP-C, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-NP279714 Issued in GA

Practice address

2782 N Cobb Pkwy
Kennesaw, GA 30152-3472

Phone

(866) 389-2727

NPI assigned

Apr 18, 2022

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, NY2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  GA

  Medicare reassignment NPD
• Matrix Medical of New York PC

  • Nurse Practitioner
  • New York, NY
  • NPI 1639433063
  Medicare reassignment NPD
• Solaire Integrative Health

  • Family Nurse Practitioner
  • Marietta, GA
  • NPI 1841139524
  NPD Authorized official
• Southeastern Endocrine & Diabetes, P.C.

  • Endocrinology, Diabetes & Metabolism Physician
  • Roswell, GA
  • NPI 1598746059
  NPD (past)

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1477296366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2782 N COBB PKWY",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2782 N COBB PKWY",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523472",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSONG",
        "first_name": "JACKIE",
        "middle_name": "MARYLINE",
        "credential": "FNP-C, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP279714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tao Lanita Bartleson-Mosley, LCSW
• Nicole Bartlett, RBT
• Salman Baseer, MD
• Macauly Basham, LMT
• Thomas Watson Bass III, L.P.C
• Jean Bastia, FNP
• Nicole Bateham
• Carlene Verona Battiste-Downie, LCSW
• Taylor Baumaister
• Robin Kersey Bayerl

• Family Nurse Practitioner in Kennesaw, GA
• Providers in Kennesaw, 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 Jun 19, 2026; 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.