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DR. JACKSON L GATES M.D.
NPI 1962418400
General Practice in Conyers, GA

Active since August 01, 2006PECOS Enrolled
1880 LANCASTER DRIVE, CONYERS, GA 30013(678) 591-6509 Get Directions Write a Review

NPPES record last updated: August 10, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jackson L Gates M.d. NPPES

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

DR. JACKSON L GATES M.D. (NPI 1962418400) is an individual general practice provider in Conyers, Georgia, licensed in Georgia (038767) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962418400
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. JACKSON L GATESCredential: M.D.
Location Address1880 LANCASTER DRIVEConyers, GA 30013-6433
Mailing Address777 Cleveland Ave Sw, Suite 100Atlanta, GA 30315-7129 · (404) 763-0093
Phone(678) 591-6509
Sole ProprietorYes
Enumeration DateAugust 1, 2006
Last NPPES UpdateAugust 10, 2010
✔ NPI 1962418400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in GA · 038767
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedPathology · Anatomic Pathology & Clinical PathologyTaxonomy 207ZP0102X · License 038767 (GA)
1880 LANCASTER DRIVE, Conyers, GA 30013
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Other Identifiers 1

Medicare UPING98376

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jackson L Gates M.d. 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.

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 Jackson Gates's NPI number?

The NPI number for Jackson Gates is 1962418400. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Jackson Gates located?

Jackson Gates practices at 1880 Lancaster Drive, Conyers, GA 30013. The listed phone number is (678) 591-6509.

What is Jackson Gates's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Jackson Gates enrolled in Medicare?

Yes. Jackson Gates is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jackson Gates was last updated on August 10, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.