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MRS. CARROLL DAVIS JACKSON APRN
NPI 1982111704
Nurse Practitioner - Family in Adel, GA

Active since January 02, 2018PECOS EnrolledAccepts Medicare Assignment
172 MJ TAYLOR RD, ADEL, GA 31620(229) 896-8500 Get Directions Write a Review

NPPES record last updated: October 13, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Carroll Davis Jackson Aprn NPPES

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

MRS. CARROLL DAVIS JACKSON APRN (NPI 1982111704) is an individual family provider in Adel, Georgia, licensed in Georgia (NP167907) and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1982111704
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. CARROLL DAVIS JACKSONCredential: APRN
Location Address172 MJ TAYLOR RDAdel, GA 31620-3497
Mailing Address907 18th St E Ste 400Tifton, GA 31794-3684 · (229) 353-3422 · Fax (229) 353-6060
Phone(229) 896-8500
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJanuary 2, 2018
Last NPPES UpdateOctober 13, 2025
NPPES CertifiedOctober 13, 2025
✔ NPI 1982111704 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 · NP167907
172 MJ TAYLOR RD, Adel, GA 31620
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Carroll Davis Jackson Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547698508
PECOS Enrollment IDI20200325002168
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 Carroll Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Tift Regional Health System Inc
Same address
Cardiovascular Disease
150 MJ TAYLOR RD
Adel, GA 31620
  • Reassigned Medicare billing, Georgia enrollment
  • 380 clinicians in this Medicare group
NPI 1750215323 (229) 896-8440

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 31620 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 11

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

VINCENT VALENCIA M.D.
Family Medicine
172 MJ TAYLOR RD
ADEL, GA 31620
Cook County (229) 896-8500
MRS. PRISCILLA R GREENE FHNP
Nurse Practitioner (Family)
172 MJ TAYLOR RD
ADEL, GA 31620
Cook County (229) 896-5200
TIMANTHA D BOOTH PA
Physician Assistant
172 MJ TAYLOR RD
ADEL, GA 31620
Cook County (229) 896-3424
KATIE M HUDGENS MD
Internal Medicine
172 MJ TAYLOR RD
ADEL, GA 31620
Cook County (229) 896-8500
WALTER STONE NP
Nurse Practitioner
172 MJ TAYLOR RD
ADEL, GA 31620
Cook County (229) 896-8500
MELISSA MICHELLE ROBERTS FNP-C
Nurse Practitioner (Family)
172 MJ TAYLOR RD
ADEL, GA 31620
Cook County (229) 896-3424
KELLY MARIE DELGADO MD
Family Medicine
172 MJ TAYLOR RD
ADEL, GA 31620
Cook County (229) 896-8500
CAROLINE HENDLEY FNP-C
Nurse Practitioner (Family)
172 MJ TAYLOR RD
ADEL, GA 31620
Cook County (229) 896-8500

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 Carroll Jackson's NPI number?

The NPI number for Carroll Jackson is 1982111704. It was assigned to this individual provider in the NPPES registry on January 2, 2018.

Where is Carroll Jackson located?

Carroll Jackson practices at 172 Mj Taylor Rd, Adel, GA 31620. The listed phone number is (229) 896-8500.

What is Carroll Jackson's specialty?

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

Is Carroll Jackson enrolled in Medicare?

Yes. Carroll Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Carroll Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carroll Jackson reassigns Medicare benefits to Tift Regional Health System Inc (Adel, GA). The 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 Carroll Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carroll Jackson accept?

Health plans from Alliant Health Plans, Inc. and Oscar Health list Carroll Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carroll Jackson was last updated on October 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.