MR. ELLIS R JACKSON CRNA
NPI 1659362283
Nurse Anesthetist, Certified Registered in Macon, GA
About Mr. Ellis R Jackson Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. ELLIS R JACKSON CRNA (NPI 1659362283) is an individual nurse anesthetist, certified registered in Macon, Georgia, licensed in Georgia (RN066377) and active in the NPI registry since November 2005. He is a graduate of Other (1991).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
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
Mr. Ellis R Jackson Crna 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 Reassignments
5Medicare enrollment records show Ellis Jackson reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Macon, GA 31201
- Reassigned Medicare billing, Georgia enrollment
- 34 clinicians in this Medicare group
Atlanta, GA 30303
- Reassigned Medicare billing, Georgia enrollment
- 42 clinicians in this Medicare group
Fitzgerald, GA 31750
- Reassigned Medicare billing, Georgia enrollment
- Medicare enrollment name: Phoebe Physician Group Inc
- 1,118 clinicians in this Medicare group
Moultrie, GA 31768
- Reassigned Medicare billing, Georgia enrollment
- 26 clinicians in this Medicare group
Bradenton, FL 34208
- Reassigned Medicare billing, Georgia enrollment
- 386 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 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 31201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MACON, GA 31201
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 Ellis Jackson's NPI number?
The NPI number for Ellis Jackson is 1659362283. It was assigned to this individual provider in the NPPES registry on November 2, 2005.
Where is Ellis Jackson located?
Ellis Jackson practices at 610 3rd St, Macon, GA 31201. The listed phone number is (229) 344-6080.
What is Ellis Jackson's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Ellis Jackson enrolled in Medicare?
Yes. Ellis 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 organizations bill Medicare for Ellis Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ellis Jackson reassigns Medicare benefits to 5 organizations: Macon Gastroenterology Anesthesia Associates LLC (Macon, GA), Xenon Anesthesia Of Georgia LLC (Atlanta, GA), Phoebe Dorminy Family Care (Fitzgerald, GA), Colquitt Regional Anesthesia, LLC (Moultrie, GA) and Anesthesia Dynamics LLC (Bradenton, FL). 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 Ellis Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Ellis Jackson was last updated on April 12, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Mr. Ellis R Jackson, CRNA · NPI 1659362283
Nurse Anesthetist, Certified Registered physician in Macon, Georgia. Individual provider, active in the CMS NPPES registry since November 2, 2005.
## Identity
- **NPI:** 1659362283 (Entity type: Individual)
- **Enumerated:** November 2, 2005
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** RN066377 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 610 3RD ST, Macon, GA 31201-3294
- **Phone:** (229) 344-6080 · **Fax:** (229) 436-8649
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Macon Gastroenterology Anesthesia Associates LLC (NPI 1922463132, Macon, GA); Xenon Anesthesia Of Georgia LLC (NPI 1366865123, Atlanta, GA); Phoebe Dorminy Family Care (NPI 1992084644, Fitzgerald, GA); Colquitt Regional Anesthesia, LLC (NPI 1154580512, Moultrie, GA); Anesthesia Dynamics LLC (NPI 1073001012, Bradenton, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1991
## Record status
- **NPPES last updated:** April 12, 2017
- **Other identifiers:** Medicare UPIN P43966; Medicaid 334081730A (GA); Medicare PIN 43ZCCCR03 (GA); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1659362283) · Data from the CMS NPPES public registry.