NICOLE SUTTON JACK – Occupational Therapist, NPI 1194112532
Occupational Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
487 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in GA
Provider Addresses for NICOLE SUTTON JACK
804 TOWNE PARK DR
SUITE 400
RINCON, GA 313265133
Phone: (912) 826-5450
Fax: (912) 826-6413
Type: Mailing
3000 EDWARD CURD LN
FRANKLIN, TN 370675791
Phone: (615) 791-2630
Fax: (615) 791-2639
Type: Mailing
804 Towne Park Dr
Suite 400
Rincon, GA 313265133
Phone: (912) 826-5450
Fax: (912) 826-6413
Type: Location
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: 2019-09-18
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190918002373 | I | Occupational Therapist In Private Practice | TN | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 646 | 74 | $0 |
| 97530 | Therapy procedure using functional activities | 71 | 30 | $0 |
| 97165 | Evaluation for occupational therapy, typically 30 minutes | 60 | 60 | $0 |
| 97150 | Therapy procedure in a group setting | 29 | 12 | $0 |
Insurance plans in this area (ZIP 31326)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | TN | |
| Physician Assistant | TN | |
| Orthopedic Surgery | TN | |
| Physical Therapist In Private Practice | TN | |
| Physical Therapist In Private Practice | TN | |
| Physician Assistant | TN | |
| Physician Assistant | TN | |
| Physician Assistant | TN | |
| Physical Therapist In Private Practice | TN | |
| Hand Surgery, Sports Medicine, Orthopedic Surgery | TN |
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