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 and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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
Ms. Jacqueline Denise Ross Crnp 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.
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 system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
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 18 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 (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2019
## 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.