MELVIN JACKSON NP
NPI 1679451249
Nurse Practitioner in Newnan, GA

Q: What is Melvin Jackson's NPI number?

The NPI number for Melvin Jackson is 1679451249. It was assigned to this individual provider in the NPPES registry on August 22, 2025.

Q: What is Melvin Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Melvin Jackson was last updated on June 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since August 22, 2025PECOS Enrolled

745 POPLAR RD, NEWNAN, GA 30265(770) 400-2353 Get Directions Write a Review

NPPES record last updated: June 10, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Melvin Jackson Np NPPES

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

MELVIN JACKSON NP (NPI 1679451249) is an individual nurse practitioner in Newnan, Georgia, licensed in Georgia (APRN-NP309363) and active in the NPI registry since August 2025. He is enrolled in Medicare PECOS, maintains a secondary practice location in Macon, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1679451249

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameMELVIN JACKSONCredential: NP

Location Address745 POPLAR RDNewnan, GA 30265-1618

Mailing Address1066 Alma DrMacon, GA 31216-6195

Phone(770) 400-2353

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateAugust 22, 2025

Last NPPES UpdateJune 10, 2026

NPPES CertifiedJune 10, 2026

✔ NPI 1679451249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in GA · APRN-NP309363

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License RN309363 (GA)

745 POPLAR RD, Newnan, GA 30265

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Secondary Practice Location 1

Location 11066 Alma DrMacon, GA 31216-6195 · Phone (478) 951-3820

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID7618442856

PECOS Enrollment IDI20260406003097

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.

Medicare Billing Reassignment

Medicare enrollment records show Melvin Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Piedmont Hospitalist Physicians LLC

32 mi

Family Medicine

1133 EAGLES LANDING PKWY
Stockbridge, GA 30281

Reassigned Medicare billing, Georgia enrollment
792 clinicians in this Medicare group

NPI 1548219660 (770) 801-2500

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 30265 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 20

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

AUDREY FONKAM MD

Internal Medicine