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DR. BETHANY WALL JACKSON M.D.
NPI 1033396841
Pediatrics in Rome, GA

Active since January 23, 2008PECOS Enrolled
2112 SHORTER AVE NW STE 240, ROME, GA 30165(706) 368-8575(706) 204-9430 Get Directions Write a Review

NPPES record last updated: April 16, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 16, 2024, Mar 10, 2023, Nov 18, 2022 and 2 more (5 updates tracked since 2017).

About Dr. Bethany Wall Jackson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BETHANY WALL JACKSON M.D. (NPI 1033396841) is an individual pediatrics provider in Rome, Georgia, licensed in Georgia (060642) and active in the NPI registry since January 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033396841
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. BETHANY WALL JACKSONCredential: M.D.
Location Address2112 SHORTER AVE NW STE 240Rome, GA 30165-2042
Mailing AddressPo Box 12938, C/o Clinic ManagementCalhoun, GA 30703 · (706) 602-7800
Phone(706) 368-8575
Fax(706) 204-9430
Sole ProprietorNo
Enumeration DateJanuary 23, 2008
Last NPPES UpdateApril 16, 20245 updates tracked since enumeration
NPPES CertifiedApril 16, 2024
✔ NPI 1033396841 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in GA · 060642
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2112 SHORTER AVE NW STE 240, Rome, GA 30165
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Other Names 1

Former Name (1)Ms. Bethany Jean Wall P.a.-c.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Bethany Wall Jackson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Bethany Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Adventist Health System Georgia Inc
24 mi
Multi-Specialty
1035 RED BUD RD NE
Calhoun, GA 30701
  • Reassigned Medicare billing, Georgia enrollment
  • 384 clinicians in this Medicare group
NPI 1699791343 (706) 602-7800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30165 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bethany Jackson's NPI number?

The NPI number for Bethany Jackson is 1033396841. It was assigned to this individual provider in the NPPES registry on January 23, 2008. The provider is also known as Ms. Bethany Jean Wall P.A.-C..

Where is Bethany Jackson located?

Bethany Jackson practices at 2112 Shorter Ave NW Ste 240, Rome, GA 30165. The listed phone number is (706) 368-8575.

What is Bethany Jackson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Bethany Jackson enrolled in Medicare?

Yes. Bethany Jackson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Bethany Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bethany Jackson reassigns Medicare benefits to Adventist Health System Georgia Inc (Calhoun, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bethany Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Bethany Jackson accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Bethany Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bethany Jackson was last updated on April 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.