NPIMap

Individual provider Active NPI

Joseph M Jackson III, MD

  • Family Medicine Physician
  • Albany, GA
National Provider Identifier
1811980352
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
039374 Issued in GA
Practice address
2701 Meredyth Dr
Albany, GA 31707-2267
Phone
(229) 883-7010
Fax
(229) 435-4022
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 039374 GA Primary

Addresses

Primary practice location

2701 Meredyth Dr
Albany, GA 31707-2267

Mailing address

2701 Meredyth Dr
Albany, GA 31707-2267
Phone (229) 883-7010

Other identifiers 1

IdentifierTypeStateIssuer
00706417EMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100722000795 GA Practitioner - Family Practice 5092847202 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

Hospital & facility affiliations

  • Amedisys Home Health of Macon Home health agency, Macon, GA, CCN 117093
  • Centerwell Home Health Home health agency, Albany, GA, CCN 117141
  • Amedisys Home Health Home health agency, Tifton, GA, CCN 117077
  • Phoebe Putney Memorial Hospital Hospital, Albany, GA, CCN 110007
  • Phoebe Worth Medical Center Hospital, Sylvester, GA, CCN 111328
  • Phoebe Sumter Medical Center Hospital, Americus, GA, CCN 110044

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
039374GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Apr 21, 2020 Accepting new patients
The Veranda, PC Family Medicine CurrentSince Jun 1, 2002 Accepting new patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Apr 21, 2020 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

2701 Meredyth Dr
Albany, GA 31707
Phone (229) 883-7010

2701 Meredyth Dr
#M
Albany, GA 31707

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: joseph.jackson.iii.1@8042.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1811980352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 MEREDYTH DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072267",
            "telephone_number": "229-883-7010",
            "fax_number": "229-435-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 MEREDYTH DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072267",
            "telephone_number": "229-883-7010",
            "fax_number": "229-435-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "039374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00706417E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.