Active NPI
Carrie B. Jackson, RN, BSN, MBA
- Registered Nurse
- Stockbridge, GA
National Provider Identifier
1891054268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN070257
- Practice address
- 157 Burke St Ste 119
Stockbridge, GA 30281-3444 - Phone
- (678) 249-9311
- Fax
- (404) 393-7767
- NPI assigned
- May 4, 2012
- Last updated
- Feb 9, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN070257 | GA | Primary |
Addresses
Primary practice location
157 Burke St Ste 119
Stockbridge, GA 30281-3444
Mailing address
25 Cloud Forest CT
Stockbridge, GA 30281-1451
Phone (770) 377-4834
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Master of Business Administration, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN070257 | GA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Just a Journey Counseling & Psychological Services, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Stockbridge, GA
- NPI 1811254964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486598400000",
"number": "1891054268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 CLOUD FOREST CT",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302811451",
"telephone_number": "770-377-4834",
"fax_number": "404-393-7767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "157 BURKE ST STE 119",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302813444",
"telephone_number": "678-249-9311",
"fax_number": "404-393-7767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CARRIE",
"middle_name": "B.",
"credential": "RN, BSN, MBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-04",
"last_updated": "2017-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "RN070257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockbridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.