ANCELLE MAE JACKSON APRN
NPI 1477027373
Nurse Practitioner - Family in Bonaire, GA

Q: What is Ancelle Mae Jackson's NPI number?

The NPI number for Ancelle Mae Jackson is 1477027373. It was assigned to this individual provider in the NPPES registry on January 14, 2019.

Q: What is Ancelle Mae Jackson's specialty?

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

Active since January 14, 2019PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

774 HIGHWAY 96, BONAIRE, GA 31005(478) 988-5711 Get Directions Write a Review

NPPES record last updated: October 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 18, 2021, May 28, 2021, Jan 14, 2019 (3 updates tracked since 2019).

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About Ancelle Mae Jackson Aprn NPPES

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

ANCELLE MAE JACKSON APRN (NPI 1477027373) is an individual family provider in Bonaire, Georgia, licensed in Georgia (RN300851) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1477027373

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameANCELLE MAE JACKSONCredential: APRN

Location Address774 HIGHWAY 96Bonaire, GA 31005-3300

Mailing Address1428 Ridge Brook TrlDuluth, GA 30096-6810

Phone(478) 988-5711

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJanuary 14, 2019

Last NPPES UpdateOctober 13, 20253 updates tracked since enumeration

NPPES CertifiedOctober 13, 2025

✔ NPI 1477027373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN300851

Also ListedNurse PractitionerTaxonomy 363L00000X · License 11000926 (FL)

774 HIGHWAY 96, Bonaire, GA 31005

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.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

Ancelle Mae Jackson Aprn 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 ID6901206341

PECOS Enrollment IDI20210607002359

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 4

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.

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.

17 services15 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

16 services16 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

16 services16 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

13 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31005 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.

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.

100/100

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

Scored as part of a group practice

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 5

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

LINDA DYER RPH