CHANDA WALLER JACKSON NP
NPI 1245742329
Nurse Practitioner in Atlanta, GA
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
Specialties & Licenses 2
Secondary Practice Location 1
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
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.
Medicare Billing Reassignment
Medicare enrollment records show Chanda Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Atlanta, GA 30322
- Reassigned Medicare billing, Georgia enrollment
- 4,840 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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, GAPhysician 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.
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.
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.
ATLANTA, GA 30309
ATLANTA, GA 30309
ATLANTA, GA 30309
ATLANTA, GA 30309
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 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.
Where is Chanda Jackson located?
Chanda Jackson practices at 95 Collier Rd NW Ste 5015, Atlanta, GA 30309. The listed phone number is (404) 605-6517.
What is Chanda Jackson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Chanda Jackson enrolled in Medicare?
Yes. Chanda Jackson 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 organization bills Medicare for Chanda Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Chanda Jackson reassigns Medicare benefits to The Emory Clinic Inc (Atlanta, 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 Chanda Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Chanda Jackson affiliated with any hospitals?
According to CMS data, Chanda Jackson is affiliated with Emory University Hospital.
When was this NPI record last updated?
The NPPES record for Chanda Jackson was last updated on June 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Chanda Waller Jackson, NP · NPI 1245742329
Nurse Practitioner physician in Atlanta, Georgia. Individual provider, active in the CMS NPPES registry since October 30, 2017.
## Identity
- **NPI:** 1245742329 (Entity type: Individual)
- **Enumerated:** October 30, 2017
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** RN213894 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 95 COLLIER RD NW STE 5015, Atlanta, GA 30309-1721
- **Phone:** (404) 605-6517
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** The Emory Clinic Inc (NPI 1396798229, Atlanta, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** June 15, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1245742329) · Data from the CMS NPPES public registry.