KIBIBI A JACKSON FNP-BC
NPI 1831790526
Nurse Practitioner - Family in Riverdale, GA
About Kibibi A Jackson Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIBIBI A JACKSON FNP-BC (NPI 1831790526) is an individual family provider in Riverdale, Georgia, licensed in Georgia (RN265070) and active in the NPI registry since November 2020. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kibibi A Jackson Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30274 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 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
RIVERDALE, GA 30274
RIVERDALE, GA 30274
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 Kibibi Jackson's NPI number?
The NPI number for Kibibi Jackson is 1831790526. It was assigned to this individual provider in the NPPES registry on November 8, 2020.
Where is Kibibi Jackson located?
Kibibi Jackson practices at 483 Upper Riverdale Rd SW, Riverdale, GA 30274. The listed phone number is (770) 996-9400.
What is Kibibi Jackson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kibibi Jackson enrolled in Medicare?
Yes. Kibibi Jackson is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kibibi Jackson was last updated on February 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Kibibi A Jackson, FNP-BC · NPI 1831790526
Family physician in Riverdale, Georgia. Individual provider, active in the CMS NPPES registry since November 8, 2020.
## Identity
- **NPI:** 1831790526 (Entity type: Individual)
- **Enumerated:** November 8, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** RN265070 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 483 UPPER RIVERDALE RD SW, Riverdale, GA 30274-2584
- **Phone:** (770) 996-9400
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** February 18, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1831790526) · Data from the CMS NPPES public registry.