Melvin Jackson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN-NP309363 Issued in GA

Practice address

745 Poplar Rd
Newnan, GA 30265-1618

Phone

(770) 400-2353

NPI assigned

Aug 22, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Piedmont Hospitalist Physicians LLC

  • Family Medicine Physician
  • Stockbridge, GA
  • NPI 1548219660
  Medicare reassignment

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1679451249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1066 ALMA DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312166195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 POPLAR RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651618",
            "telephone_number": "770-400-2353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1066 Alma Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312166195",
            "country_code": "US",
            "telephone_number": "478-951-3820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MELVIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-22",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "APRN-NP309363",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN309363",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A. Jackson, NP-C
• Henry Jackson, DMD
• Lewis W. Jackson, M.D.
• Malasia Jackson, RBT
• Mallory Charlene Jackson
• Sandra Lynne Jackson, LPC
• Willandria S Jackson
• Richard Lee Jacobs II, MD
• Melissa Lynn Jacobson
• Stephen William Jacon

• Nurse Practitioner in Newnan, GA
• Providers in Newnan, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.