CENCEREITTE CANTY-JACKSON (FNP-C) – Nurse Practitioner, NPI 1083421242

CENCEREITTE CANTY-JACKSON (FNP-C) is a healthcare provider. based in Macon, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. RN217763 (GA). The NPI Number for CENCEREITTE CANTY-JACKSON (FNP-C) is 1083421242

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
CENCEREITTE CANTY-JACKSON (FNP-C)
NPI
1083421242
Phone
(478) 232-4590
Address
996 CHAPMAN DR
Enumeration Date
11 December 2024
Last Update Date
11 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4787389443
Graduation Year
2024 (2 years ago)
PAC ID
9335661883
Group Practice PAC ID
0345204418
Professional Enrollment ID
I20250313003409
Address ID
GA312012851MA654XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for CENCEREITTE CANTY-JACKSON (FNP-C)

  • 996 CHAPMAN DR

    MACON, GA 312117214

    Phone: (478) 232-4590

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250313003409INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31211)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345204418View full group profile
NameSpecialtyState
-GA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Cardiovascular Disease (Cardiology)GA
-GA

Reviews

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Frequently asked questions

How do payers reference CENCEREITTE CANTY-JACKSON (FNP-C)?
For CENCEREITTE CANTY-JACKSON (FNP-C), use NPI 1083421242 as the unique 10-digit identifier.
Active or inactive — what applies to CENCEREITTE CANTY-JACKSON (FNP-C)?
You should see CENCEREITTE CANTY-JACKSON (FNP-C) as active in CMS-hosted NPPES data.
What area of care is associated with CENCEREITTE CANTY-JACKSON (FNP-C)?
CENCEREITTE CANTY-JACKSON (FNP-C)'s record emphasizes Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with CENCEREITTE CANTY-JACKSON (FNP-C)?
Directory geography for CENCEREITTE CANTY-JACKSON (FNP-C) centers on Macon, Georgia.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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