CHANDA WALLER JACKSON NP
NPI 1245742329
Nurse Practitioner in Atlanta, GA

Q: What is Chanda Jackson's NPI number?

The NPI number for Chanda Jackson is 1245742329. It was assigned to this individual provider in the NPPES registry on October 30, 2017.

Q: What is Chanda Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Chanda Jackson was last updated on June 15, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 30, 2017PECOS EnrolledAccepts Medicare Assignment

92.26/100

CMS Quality Rating

95 COLLIER RD NW STE 5015, ATLANTA, GA 30309(404) 605-6517 Get Directions Write a Review

NPPES record last updated: June 15, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 15, 2023, Oct 30, 2017 (2 updates tracked since 2017).

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About Chanda Waller Jackson Np NPPES

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

CHANDA WALLER JACKSON NP (NPI 1245742329) is an individual nurse practitioner in Atlanta, Georgia, licensed in Georgia (RN213894) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS, is affiliated with Emory University Hospital, and maintains a secondary practice location in Atlanta.

NPPES Registry Identity

NPI1245742329

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameCHANDA WALLER JACKSONCredential: NP

Location Address95 COLLIER RD NW STE 5015Atlanta, GA 30309-1721

Mailing Address550 Peachtree Street, Davis Fisher Building, Office 3245aAtlanta, GA 30308 · (404) 686-7858

Phone(404) 605-6517

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateOctober 30, 2017

Last NPPES UpdateJune 15, 20232 updates tracked since enumeration

NPPES CertifiedJune 15, 2023

✔ NPI 1245742329 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in GA · RN213894

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X · License RN213894 (GA)

95 COLLIER RD NW STE 5015, Atlanta, GA 30309

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Secondary Practice Location 1

Location 1550 Peachtree Street, Davis Fischer Bldg, Office 3245AAtlanta, GA 30308 · Phone (404) 686-7858

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

Chanda Waller 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 ID2365702958

PECOS Enrollment IDI20180130000577

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.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

35 services20 patients

Critical care, each additional 30 minutes 99292

Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.

34 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Emory University Hospital

Acute Care Hospitals · Atlanta, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110010

Location1364 Clifton Road, NEAtlanta, GA 30322 · De Kalb County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30309 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.26/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

73.83

Promoting Interoperability

100

Improvement Activities

Leave this field empty

Other Providers at the Same Location NPPES 20

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

RAMONA DAVIS PA

Physician Assistant