NPIMap

Organization Active NPI

Supportive Medicine Specialists, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Atlanta, GA
National Provider Identifier
1689329476
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
SUPPORTIVE MEDICINE SPECIALISTS, PC
Practice address
1800 Howell Mill Rd
Suite 800
Atlanta, GA 30318
Phone
(470) 830-2221
NPI assigned
Feb 20, 2022
Last updated
Mar 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Dr. Joshua Jackson, MDNPI 1528441870
Title
Ceo/ Physician
Phone
(470) 830-2221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0002X Primary

Addresses

Primary practice location

1800 Howell Mill Rd
Suite 800
Atlanta, GA 30318

Mailing address

2870 Peachtree Rd
#364
Atlanta, GA 30305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220526000877 GA Part B Supplier - Clinic/Group Practice 2769860121 Receives reassigned benefits from 5 practitioners
Practice locations: Augusta, GA; Monroe, GA; Jasper, GA; Covington, GA; Conyers, GA; Columbus, GA; Atlanta, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1645315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1689329476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2870 PEACHTREE RD",
            "address_2": "#364",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOWELL MILL RD",
            "address_2": "SUITE 800",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30318",
            "telephone_number": "470-830-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE MEDICINE SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-20",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CEO/ PHYSICIAN",
        "authorized_official_telephone_number": "470-830-2221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.