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JACKSON BRYANT COOK
NPI 1164304580
Nurse Practitioner - Family in Carrollton, GA

Active since July 24, 2025PECOS EnrolledAccepts Medicare Assignment
706 DIXIE ST STE 220, CARROLLTON, GA 30117(770) 812-8640(770) 838-8650 Get Directions Write a Review

NPPES record last updated: October 10, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jackson Bryant Cook NPPES

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

JACKSON BRYANT COOK (NPI 1164304580) is an individual family provider in Carrollton, Georgia, licensed in Georgia (APRN-NP316440) and active in the NPI registry since July 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1164304580
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJACKSON BRYANT COOK
Location Address706 DIXIE ST STE 220Carrollton, GA 30117-3889
Mailing Address5725 Brenda Dr SwMableton, GA 30126-3121 · (256) 278-8842
Phone(770) 812-8640
Fax(770) 838-8650
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateJuly 24, 2025
Last NPPES UpdateOctober 10, 2025
NPPES CertifiedOctober 10, 2025
✔ NPI 1164304580 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 · APRN-NP316440
706 DIXIE ST STE 220, Carrollton, GA 30117
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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

Jackson Bryant Cook 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 ID7618476979
PECOS Enrollment IDI20250814004947
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 Reassignments

2

Medicare enrollment records show Jackson Cook reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Tanner Medical Group Inc
1.4 mi
Cardiovascular Disease
100 GREENWAY BLVD FL 2
Carrollton, GA 30117
  • Reassigned Medicare billing, Georgia enrollment
  • 232 clinicians in this Medicare group
NPI 1396979787 (770) 838-8710
Tmc Immediate Care, Inc
15 mi
Urgent Care
101 QUARTZ DR, SUITE 101
Villa Rica, GA 30180
  • Reassigned Medicare billing, Georgia enrollment
  • 45 clinicians in this Medicare group
NPI 1386708097 (770) 949-7500

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 30117 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.

Other Providers at the Same Location NPPES 7

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

SAVANNAH TURNER TAYLOR
Nurse Practitioner (Family)
706 DIXIE ST STE 220
CARROLLTON, GA 30117
Carroll County (770) 812-8825
DOVIE LOWERY NP
Nurse Practitioner (Family)
706 DIXIE ST STE 220
CARROLLTON, GA 30117
Carroll County (770) 812-8825
MS. SHEENA RENE GONZALEZ CPNP-PC
Nurse Practitioner (Pediatrics)
706 DIXIE ST STE 220
CARROLLTON, GA 30117
Carroll County (770) 812-8825
DR. RUTH ANNE FARRELL M.D.
Obstetrics & Gynecology
706 DIXIE ST STE 220
CARROLLTON, GA 30117
Carroll County (770) 214-2121
TIFFANY ROCHELLE HOPSON NP
Nurse Practitioner (Pediatrics)
706 DIXIE ST STE 220
CARROLLTON, GA 30117
Carroll County (770) 812-8825
MS. NANCY JOSEPHINE RYAN C.P.N.P.
Nurse Practitioner (Pediatrics)
706 DIXIE ST STE 220
CARROLLTON, GA 30117
Carroll County (770) 812-8825
MRS. ALAYNE CHRISTINE THOMPSON CRNP
Nurse Practitioner (Pediatrics)
706 DIXIE ST STE 220
CARROLLTON, GA 30117
Carroll County (770) 812-8825

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 Jackson Cook's NPI number?

The NPI number for Jackson Cook is 1164304580. It was assigned to this individual provider in the NPPES registry on July 24, 2025.

Where is Jackson Cook located?

Jackson Cook practices at 706 Dixie St Ste 220, Carrollton, GA 30117. The listed phone number is (770) 812-8640.

What is Jackson Cook's specialty?

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

Is Jackson Cook enrolled in Medicare?

Yes. Jackson Cook is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jackson Cook's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jackson Cook reassigns Medicare benefits to 2 organizations: Tanner Medical Group Inc (Carrollton, GA) and Tmc Immediate Care, Inc (Villa Rica, GA). Each 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 Jackson Cook's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jackson Cook was last updated on October 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.