MS. ROSLYN C BANKS-JACKSON (MD) – Obstetrics & Gynecology Physician, NPI 1134112618
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MS. ROSLYN C BANKS-JACKSON (MD)
2400, Bellevue Road, Dublin, Laurens County, Georgia, 31021, United States
STE 23
DUBLIN, GA 310212888
Phone: (478) 272-8580
Fax: (478) 275-0012
Type: Mailing
Winn Army Community Hospital, 1061, Harmon Avenue, Bowen, Fort Stewart, Liberty County, Georgia, 31314, United States
FORT STEWART, GA 31314
Phone: (912) 435-6965
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $42.
Total Amount is formed as General ($42) + Research ($0) + Ownership ($0) = $42.
Last reported payment date: 2024-09-24 • Largest payer in this snapshot: Medtronic, Inc. ($23).
Total Amount
$42
General + Research + Ownership
Payments
2
Total payment records
General Amount
$42
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $23 |
| Boston Scientific Corporation | $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: 2010-12-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20060207000302 | I | Obstetrics/Gynecology | NC | TBD |
| I20081110000577 | I | Obstetrics/Gynecology | IL | TBD |
| I20101201000734 | I | Obstetrics/Gynecology | GA | 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 31021)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | HI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | ID | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| - | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| - | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NC |
Reviews
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