NICOLE STANLEY JACKSON NP-C
NPI 1659787034
Nurse Practitioner - Family in Tennille, GA

Q: What is Nicole Jackson's NPI number?

The NPI number for Nicole Jackson is 1659787034. It was assigned to this individual provider in the NPPES registry on July 7, 2014. The provider is also known as Sharon S Massengale Np-C.

Q: What is Nicole Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nicole Jackson was last updated on October 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since July 07, 2014PECOS Enrolled

116 SMITH ST, TENNILLE, GA 31089(478) 552-1620(478) 864-1288 Get Directions Write a Review

NPPES record last updated: October 24, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Nicole Stanley Jackson Np-c NPPES

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

NICOLE STANLEY JACKSON NP-C (NPI 1659787034) is an individual family provider in Tennille, Georgia, licensed in Georgia (RN143548) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659787034

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameNICOLE STANLEY JACKSONCredential: NP-C

Location Address116 SMITH STTennille, GA 31089-1465

Mailing AddressPo Box 371Wrightsville, GA 31096-0371 · (478) 864-3448 · Fax (478) 864-1288

Phone(478) 552-1620

Fax(478) 864-1288

Sole ProprietorNo

Enumeration DateJuly 7, 2014

Last NPPES UpdateOctober 24, 2023

NPPES CertifiedOctober 23, 2023

✔ NPI 1659787034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN143548

116 SMITH ST, Tennille, GA 31089

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Other Names 1

Former Name (1)Sharon S Massengale Np-c

Other Identifiers 2

OtherF0414179GA · American Academy Of Nurse Practitioners

OtherRN143548GA · Georgia Secretary Of State

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Stanley Jackson Np-c 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31089 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.

Other Providers at the Same Location NPPES 7

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

ALESHA MICHELLE EDWARDS D.P.M.

Podiatrist (Foot & Ankle Surgery)