MRS. SOPHIA EVETTE JACKSON NP
NPI 1093879769
Nurse Practitioner - Family in Buford, GA

Q: What is Sophia Jackson's NPI number?

The NPI number for Sophia Jackson is 1093879769. It was assigned to this individual provider in the NPPES registry on December 20, 2006.

Q: What is Sophia Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Sophia Jackson was last updated on September 16, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since December 20, 2006PECOS EnrolledAccepts Medicare Assignment

1950 BUFORD HWY, CVS CAREMARK MINUTE CLINIC, BUFORD, GA 30518(770) 945-7286 Get Directions Write a Review

NPPES record last updated: September 16, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Mrs. Sophia Evette Jackson Np NPPES

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

MRS. SOPHIA EVETTE JACKSON NP (NPI 1093879769) is an individual family provider in Buford, Georgia, licensed in Georgia (RN117221) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1093879769

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. SOPHIA EVETTE JACKSONCredential: NP

Location Address1950 BUFORD HWY, CVS CAREMARK MINUTE CLINICBuford, GA 30518-3673

Mailing Address4249 Brentwood DrBuford, GA 30518-9008 · (770) 292-8634 · Fax (770) 965-2269

Phone(770) 945-7286

Sole ProprietorNo

Medical School CMSOtherGraduated 1997

Enumeration DateDecember 20, 2006

Last NPPES UpdateSeptember 16, 2013

✔ NPI 1093879769 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN117221

1950 BUFORD HWY, Buford, GA 30518

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Other Identifiers 2

Medicaid00792426CGA

Medicare UPINS56481GA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Sophia Evette Jackson Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870570146

PECOS Enrollment IDI20260302000420

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

14 services11 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

13 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30518 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLUTOLA ADU PHARMD

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