JACKSON HEDRICK SALLEY
NPI 1609677673
Student in an Organized Health Care Education/Training Program in Savannah, GA

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 24, 2025PECOS Enrolled

4700 WATERS AVE, SAVANNAH, GA 31404(912) 350-3595 Get Directions Write a Review

NPPES record last updated: March 24, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jackson Hedrick Salley NPPES

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

JACKSON HEDRICK SALLEY (NPI 1609677673) is an individual student in an organized health care education/training program in Savannah, Georgia and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609677673

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACKSON HEDRICK SALLEY

Location Address4700 WATERS AVESavannah, GA 31404-6220

Mailing Address4700 Waters AveSavannah, GA 31404-6220 · (912) 350-3595

Phone(912) 350-3595

Sole ProprietorNo

Enumeration DateMarch 24, 2025

NPPES CertifiedMarch 24, 2025

✔ NPI 1609677673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4700 WATERS AVE, Savannah, GA 31404

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackson Hedrick Salley is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.