Michelle Jackson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

298929 Issued in GA

Practice address

4593 Lawrenceville Road
Loganville, GA 30052

Phone

(770) 466-8672

NPI assigned

Dec 1, 2015

Last updated

Feb 25, 2021By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• William a. Delp,Jr. DO,PC

  dba Loganville Family Medicine

  • Family Medicine Physician
  • Loganville, GA
  • NPI 1104004209
  NPD (past)

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1649645730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1908",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783326",
            "telephone_number": "770-466-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4593 LAWRENCEVILLE ROAD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "30052",
            "telephone_number": "770-466-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9171924",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP 9171924",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "298929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ipride Transport Solutions, LLC
• Keith Isaac
• Glenda Ivey, MASSAGE THERAPIST
• Keriana Edwina Jackson
• Latoria Nicole Jackson
• Stephanie D Jackson, RN
• Rasid Jakupovic
• Emily Jannine Jamshedi, PA-C
• JD Preferred Home Care Agency LLC
• Michel Jeannot

• Family Nurse Practitioner in Loganville, GA
• Providers in Loganville, 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 Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.