Individual provider Active NPI

Stephen Jackson, M.D.

  • Emergency Medicine Physician
  • East Point, GA
National Provider Identifier
1659733491
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
82539 Issued in GA
Practice address
1170 Cleveland Ave
East Point, GA 30344-3615
Phone
(404) 466-1600
NPI assigned
Mar 22, 2016
Last updated
Aug 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 217666 NC
Emergency Medicine Physician 207P00000X 82539 GA Primary

Addresses

Primary practice location

1170 Cleveland Ave
East Point, GA 30344-3615

Mailing address

1170 Cleveland Ave
East Point, GA 30344-3615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190610001815 GA Practitioner - Emergency Medicine 9335472182 Reassigns benefits to 5 organizations
I20210716001290 NC Practitioner - Emergency Medicine 9335472182 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Georgia School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stallings Emergency Physicians PLLCGroup PAC ID 2769870971, 22 clinicians
Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians
The Carolinas Emergency Group, PLLCGroup PAC ID 2567486814, 62 clinicians

Practice addresses (Care Compare)

1000 Healing Way
Matthews, NC 28104-4969
Phone (980) 993-2000

1130 Tree of Life LN
Cornelius, NC 28301-0000
Phone (888) 892-3204

11516 Providence Rd
Charlotte, NC 28277-2691
Phone (704) 667-0370

600 Hospital Dr
Monroe, NC 28112-6000
Phone (980) 993-3100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
98.67
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.01 of 100Reported as group
Quality
80.14
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.15 of 100Reported as group
Quality
81.36
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
217666NCMDRegistered Nurse
82539GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Carolina Emergency Physicians, PLLC Emergency Medicine CurrentSince May 1, 2025 Accepting new patients
Ballantyne Emergency Physicians PLLC Emergency Medicine CurrentSince Jun 25, 2021 Accepting new patients
Stallings Emergency Physicians, PLLC Emergency Medicine CurrentSince Dec 1, 2021 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jan 15, 2021 Accepting new patients
Wake Forest Emergency Providers CurrentSince Aug 24, 2025 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince May 18, 2023 Accepting new patients
Ballantyne Emergency Physicians PLLC Emergency Medicine CurrentSince Jun 25, 2021 Accepting new patients
The Carolinas Emergency Group, PLLC Emergency Medicine CurrentSince Jun 25, 2021 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
True North Health Navigation LLC Emergency Medicine CurrentSince Nov 25, 2020 Accepting new patients
Carolinas Medical Center Emergency Medicine CurrentSince May 23, 2022 Accepting new patients
True North Health Navigation LLC Emergency Medicine CurrentSince Nov 25, 2020 Accepting new patients
Lagrange Emergency Physicians, LLC Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
The Bortolazzo Group, LLC Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
Georgia Emergency Group, LLC Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Carolinas Medical Center CurrentSince May 23, 2022 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1 W Court Sq
Ste 750
Decatur, GA 30030
Phone (404) 494-7888

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

1050 McDonough Rd
Jackson, GA 30233
Phone (770) 775-7861

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

1514 Vernon Rd
Lagrange, GA 30240
Phone (706) 812-2369

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

301 Yadkin St
Albemarle, NC 28001
Phone (704) 984-4000

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

11516 Providence Rd
Charlotte, NC 28277
Phone (704) 667-0370

16035 Johnston Rd
Charlotte, NC 28277
Phone (704) 542-5132

1130 Tree of Life Ln
Cornelius, NC 28031
Phone (704) 512-2000

1000 Healing Way
Matthews, NC 28104
Phone (800) 821-1535

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

2301 US Highway 74 W
Wadesboro, NC 28170
Phone (704) 694-5131

2700 S Providence Rd
Waxhaw, NC 28173
Phone (704) 243-2254

1705 Tarboro St SW
Wilson, NC 27893
Phone (252) 399-8040

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: sjackson538049@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1659733491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 CLEVELAND AVE",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 CLEVELAND AVE",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443615",
            "telephone_number": "404-466-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "217666",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "82539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, GA

Sources for this page

Verify at the official NPI Registry.