CHARLES E JR. JACKSON (M.D.) – Family Medicine Physician, NPI 1366658734
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CHARLES E JR. JACKSON (M.D.)
406 S West St
Bainbridge, GA 398193918
Phone: (229) 246-6417
Type: Location
1506, Telfair Street, Dublin, Laurens County, Georgia, 31021, United States
DUBLIN, GA 310213908
Phone: (478) 272-3446
Type: Mailing
107, Fairview Park Drive, Dublin, Laurens County, Georgia, 31021, United States
DUBLIN, GA 310212501
Phone: (478) 864-3448
Fax: (478) 864-1288
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: 2010-09-07
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 |
|---|---|---|---|---|
| I20100907000333 | I | General Practice | 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 |
|---|---|---|---|---|
| 83036 | Hemoglobin a1c level | 44 | 35 | $0 |
| 81003 | Automated urinalysis test | 24 | 20 | $0 |
| 82947 | Blood glucose (sugar) level | 23 | 20 | $0 |
Insurance plans in this area (ZIP 39819)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL PRACTICE | GA | 83036 | Hemoglobin A1C level | 84 | 46 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| P O D I A T R Y | GA | |
| Internal Medicine | GA | |
| Internal Medicine, Emergency Medicine, General Practice | GA | |
| Marriage And Family Therapist | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| General Practice | GA | |
| Internal Medicine | GA | |
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| Family Practice | GA |
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