MRS. SIMONE ANNMARIE WATSON-JACKSON PMHNP
NPI 1104704519
Nurse Practitioner - Psychiatric/Mental Health in Atlanta, GA

Q: What is Simone Watson-jackson's NPI number?

The NPI number for Simone Watson-jackson is 1104704519. It was assigned to this individual provider in the NPPES registry on August 25, 2025.

Q: What is Simone Watson-jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since August 25, 2025PECOS EnrolledAccepts Medicare Assignment

901 RICE ST NW, ATLANTA, GA 30318(404) 613-2000 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Mrs. Simone Annmarie Watson-jackson Pmhnp NPPES

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

MRS. SIMONE ANNMARIE WATSON-JACKSON PMHNP (NPI 1104704519) is an individual psychiatric/mental health provider in Atlanta, Georgia, licensed in Georgia (RN294317) and active in the NPI registry since August 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1104704519

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMRS. SIMONE ANNMARIE WATSON-JACKSONCredential: PMHNP

Location Address901 RICE ST NWAtlanta, GA 30318-4938

Mailing Address901 Rice St NwAtlanta, GA 30318-4938

Phone(404) 613-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateAugust 25, 2025

NPPES CertifiedAugust 25, 2025

✔ NPI 1104704519 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in GA · RN294317

901 RICE ST NW, Atlanta, GA 30318

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Simone Annmarie Watson-jackson Pmhnp 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 ID2466921358

PECOS Enrollment IDI20260520002700

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 Simone Watson-jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PA

607 mi

Mental Health

66 W FLAGLER ST STE 900
Miami, FL 33130

Reassigned Medicare billing, Georgia and Washington enrollments
994 clinicians in this Medicare group

NPI 1245845932 (786) 244-7711

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 30318 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 6

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

WHITNEY ARYN PETTIGREW LCSW

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