MRS. SOPHIA EVETTE JACKSON (NP) – Family Nurse Practitioner, NPI 1093879769
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
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Provider Addresses for MRS. SOPHIA EVETTE JACKSON (NP)
1950, Buford Highway Northeast, Buford, Gwinnett County, Georgia, 30518, United States
CVS CAREMARK MINUTE CLINIC
BUFORD, GA 305183673
Phone: (770) 945-7286
Type: Location
4249, Brentwood Drive, Woodbridge, Buford, Hall County, Georgia, 30518, United States
BUFORD, GA 305189008
Phone: (770) 292-8634
Fax: (770) 965-2269
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $128.
Total Amount is formed as General ($128) + Research ($0) + Ownership ($0) = $128.
Last reported payment date: 2024-09-10 • Largest payer in this snapshot: Baxter Healthcare ($25).
Total Amount
$128
General + Research + Ownership
Payments
6
Total payment records
General Amount
$128
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Baxter Healthcare | $25 |
| Genentech USA, Inc. | $23 |
| PFIZER INC. | $22 |
| Takeda Pharmaceuticals U.S.A., Inc. | $21 |
| Phadia US Inc. | $19 |
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: 2026-03-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040706000098 | I | Nurse Practitioner | GA | TBD |
| I20240123003730 | I | Nurse Practitioner | SC | TBD |
| I20240221003727 | I | Nurse Practitioner | MI | TBD |
| I20260302000420 | I | Nurse Practitioner | MN | TBD |
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.
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 30518)
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