Georgia S Jackson, M.ED, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP003934 Issued in GA

Practice address

1488 Old Ocilla Rd
Tifton, GA 31794-4152

Phone

(229) 386-5200

NPI assigned

May 25, 2012

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

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

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.

• Golden Speech Therapy, Inc

  • Hearing and Speech Clinic/Center
  • Tifton, GA
  • NPI 1073041919
  Medicare reassignment NPD
• Orthopedic and Sports Physical Therapy, Inc.

  • Physical Therapist
  • Tifton, GA
  • NPI 1194796789
  NPD (past)
• Rehabilitation Services of Tifton, Inc.

  • Speech-Language Pathologist
  • Tifton, GA
  • NPI 1710958855
  NPD (past)

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337904000000",
    "number": "1649530593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944152",
            "telephone_number": "229-386-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944152",
            "telephone_number": "229-386-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GEORGIA",
        "middle_name": "S",
        "credential": "M.ED, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irwin County Hospital
• Celia Ivery, FNP
• J Branch SLP Services
• J H Harvey Co LLC
• Amy Ellis Jackson, PHARM D
• Patricia Anne James, MASSAGE THERAPIST
• Brigitte Locke Jarrard
• Joshua Jarrett, CRNA
• Moses Joshua Jefferson
• Yongmin Jerzak

• Speech-Language Pathologist in Tifton, GA
• Providers in Tifton, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.