MRS. KALITA HIGGINBOTHAM JACKSON FNP-C
NPI 1679847057
Nurse Practitioner - Family in Lawrenceville, GA
About Mrs. Kalita Higginbotham Jackson Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KALITA HIGGINBOTHAM JACKSON FNP-C (NPI 1679847057) is an individual family provider in Lawrenceville, Georgia, licensed in Georgia (RN191958) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Kalita Higginbotham Jackson Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
4Medicare enrollment records show Kalita Jackson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Lawrenceville, GA 30046
- Reassigned Medicare billing, Georgia enrollment
- 41 clinicians in this Medicare group
Lawrenceville, GA 30046
- Reassigned Medicare billing, Georgia enrollment
- Medicare enrollment name: Gwinnett Hospital System, Inc.
- 98 clinicians in this Medicare group
Atlanta, GA 30322
- Reassigned Medicare billing, Georgia enrollment
- 4,840 clinicians in this Medicare group
Rockville, MD 20854
- Reassigned Medicare billing, Georgia enrollment
- 350 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30046 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 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Kalita Jackson's NPI number?
The NPI number for Kalita Jackson is 1679847057. It was assigned to this individual provider in the NPPES registry on March 1, 2012.
Where is Kalita Jackson located?
Kalita Jackson practices at 500 Medical Center Blvd Ste 310, Lawrenceville, GA 30046. The listed phone number is (678) 629-7139.
What is Kalita Jackson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kalita Jackson enrolled in Medicare?
Yes. Kalita Jackson is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kalita Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kalita Jackson reassigns Medicare benefits to 4 organizations: Gwinnett Hospital System Gme, LLC (Lawrenceville, GA), Northside Hospital, Inc. (Lawrenceville, GA), The Emory Clinic Inc (Atlanta, GA) and Minuteclinic LLC (Rockville, MD). 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 Kalita 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 Kalita Jackson was last updated on February 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Mrs. Kalita Higginbotham Jackson, FNP-C · NPI 1679847057
Family physician in Lawrenceville, Georgia. Individual provider, active in the CMS NPPES registry since March 1, 2012.
## Identity
- **NPI:** 1679847057 (Entity type: Individual)
- **Enumerated:** March 1, 2012
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** RN191958 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 500 MEDICAL CENTER BLVD STE 310, Lawrenceville, GA 30046-3332
- **Phone:** (678) 629-7139
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Gwinnett Hospital System Gme, LLC (NPI 1780076927, Lawrenceville, GA); Northside Hospital, Inc. (NPI 1952340994, Lawrenceville, GA); The Emory Clinic Inc (NPI 1396798229, Atlanta, GA); Minuteclinic LLC (NPI 1134191836, Rockville, MD) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 8, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1679847057) · Data from the CMS NPPES public registry.