MR. DAVID RAY JACKSON (NP) – Family Nurse Practitioner, NPI 1215079983
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
Provider Addresses for MR. DAVID RAY JACKSON (NP)
PO BOX 845
QUITMAN, GA 316430845
Phone: (229) 263-8888
Fax: (229) 263-6528
Type: Mailing
204 E 4TH ST
OCILLA, GA 317741539
Phone: (229) 468-9166
Fax: (229) 468-9188
Type: Mailing
2301 N ASHLEY ST
VALDOSTA, GA 316022620
Phone: (229) 270-2403
Fax: (229) 468-0688
Type: Location
606, West Screven Street, Quitman Historic District, Quitman, Brooks County, Georgia, 31643, United States
QUITMAN, GA 316431922
Phone: (229) 263-8888
Fax: (229) 263-8888
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 22 Open Payments records for all available years, with a total value of $415.
Total Amount is formed as General ($415) + Research ($0) + Ownership ($0) = $415.
Last reported payment date: 2024-10-21 • Largest payer in this snapshot: Paratek Pharmaceuticals, Inc. ($104).
Total Amount
$415
General + Research + Ownership
Payments
22
Total payment records
General Amount
$415
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-21
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2004-03-12
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 |
|---|---|---|---|---|
| I20040312000173 | I | Nurse Practitioner | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 140 | 22 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 124 | 46 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 64 | 33 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 53 | 29 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 43 | 43 | $0 |
Insurance plans in this area (ZIP 31643)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Hospitalist, Internal Medicine | WI | |
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | FL |
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