Rebecca Dott Jackson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5467 Issued in GA

Practice address

755 Walther Rd
Lawrenceville, GA 30046-8725

Phone

(404) 252-7618

Fax

(678) 843-5525

NPI assigned

Nov 1, 2009

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

77.82 of 100Reported as group

Quality

67.82

Promoting interoperability

77

Improvement activities

40

Cost

77.43

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rjackson30977@direct.emory.org

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.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment NPD
• Northside Cardiovascular Professional Services, LLC

  • Cardiovascular Disease Physician
  • Roswell, GA
  • NPI 1518979921
  Medicare reassignment
• Cardiovascular Group, PC

  • Cardiovascular Disease Physician
  • Lawrenceville, GA
  • NPI 1215980479
  NPD (past)

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

{
    "created_epoch": "1257033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257033600000",
    "number": "1609102243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 BUBBLING CREEK RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303192104",
            "telephone_number": "404-333-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 WALTHER RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468725",
            "telephone_number": "404-252-7618",
            "fax_number": "678-843-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "REBECCA",
        "middle_name": "DOTT",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-01",
        "last_updated": "2009-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "5467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalita Higginbotham Jackson, FNP-C
• Kansington Caroline Jackson
• Keilon Latrice Jackson, CMA
• Kelly Len Jackson, N.P.
• Marshalee Jackson
• Shqunna Renee Jackson, RN
• Stefani Michon Jackson, LCSW-C
• Tiki Jackson, LMSW
• Wroksie Jackson, LCSW
• Leslie Jacobs

• Medical Physician Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2009; 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.