Kecia Strawter Jackson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

038978 Issued in GA

Practice address

8011 Mall Parkway
Kaiser Permanente Stonecrest Medical Center
Lithonia, GA 30038

Phone

(678) 323-7521

Fax

(770) 761-6626

NPI assigned

May 17, 2006

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

Other identifiers 1

Other names 1

• Kecia Antoinette Strawter Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1811949688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD, NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-364-7070",
            "fax_number": "770-761-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8011 MALL PARKWAY",
            "address_2": "KAISER PERMANENTE STONECREST MEDICAL CENTER",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "30038",
            "telephone_number": "678-323-7521",
            "fax_number": "770-761-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KECIA",
        "middle_name": "STRAWTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "038978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00617328I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KECIA",
            "last_name": "STRAWTER",
            "middle_name": "ANTOINETTE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rochell V Jackson-Frazier, REGISTERED NURSE
• Ajanay Toni Jackson
• Angela C Jackson, RD, LD
• Artimease Jackson, MBA,OTRL
• Ashley Janay Jackson, LMSW
• Kimberly L Jackson, LSW, MSW
• Marsha Jackson
• Reagen Jackson
• Sarina Jackson
• Tawanna C Jackson, MSP,CCC-SLP

• Pediatrics Physician in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.