MS. JACQUELINE DENISE ROSS CRNP
NPI 1578118048
Nurse Practitioner - Primary Care in Fayetteville, GA
About Ms. Jacqueline Denise Ross Crnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. JACQUELINE DENISE ROSS CRNP (NPI 1578118048) is an individual primary care provider in Fayetteville, Georgia, licensed in Georgia (RN323435) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ms. Jacqueline Denise Ross Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
4Medicare enrollment records show Jacqueline Ross reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fayetteville, GA 30214
- Reassigned Medicare billing, Georgia enrollment
- 759 clinicians in this Medicare group
Jonesboro, GA 30236
- Reassigned Medicare billing, Georgia enrollment
- 2 clinicians in this Medicare group
Atlanta, GA 30309
- Reassigned Medicare billing, Georgia enrollment
- 24 clinicians in this Medicare group
- Reassigned Medicare billing, Alabama enrollment
- 2 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30214 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 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FAYETTEVILLE, GA 30214
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 Jacqueline Ross's NPI number?
The NPI number for Jacqueline Ross is 1578118048. It was assigned to this individual provider in the NPPES registry on August 1, 2019. The provider is also known as Jacqueline R Johnson Crnp.
Where is Jacqueline Ross located?
Jacqueline Ross practices at 108 N Park Dr, Fayetteville, GA 30214. The listed phone number is (770) 487-7807.
What is Jacqueline Ross's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Jacqueline Ross enrolled in Medicare?
Yes. Jacqueline Ross is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Jacqueline Ross's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Ross reassigns Medicare benefits to 4 organizations: Privia Medical Group Of Georgia LLC (Fayetteville, GA), Clayton County Health District (Jonesboro, GA), Resurgia Health Solutions PC (Atlanta, GA) and Pain Management Group LLC (AL). 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 Jacqueline Ross's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacqueline Ross accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Jacqueline Ross as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jacqueline Ross was last updated on February 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.
# Ms. Jacqueline Denise Ross, CRNP · NPI 1578118048
Primary Care physician in Fayetteville, Georgia. Individual provider, active in the CMS NPPES registry since August 1, 2019.
## Identity
- **NPI:** 1578118048 (Entity type: Individual)
- **Enumerated:** August 1, 2019
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** RN323435 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 108 N PARK DR, Fayetteville, GA 30214-1645
- **Phone:** (770) 487-7807
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Privia Medical Group Of Georgia LLC (NPI 1013313857, Fayetteville, GA); Clayton County Health District (NPI 1104911924, Jonesboro, GA); Resurgia Health Solutions PC (NPI 1851702153, Atlanta, GA); Pain Management Group LLC (AL) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 13, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1578118048) · Data from the CMS NPPES public registry.