JACQUELINE SMALL – Family Nurse Practitioner, NPI 1407415615

JACQUELINE SMALL is a healthcare provider. based in Buford, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. RN224391 (GA). The NPI Number for JACQUELINE SMALL is 1407415615

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
JACQUELINE SMALL
NPI
1407415615
Phone
(770) 314-8027
Address
3910 PLANTATION MILL DR
Enumeration Date
11 June 2019
Last Update Date
11 June 2019

Doctor Profile

Medical School Name
UNIVERSITY ALABAMA BIRMINGHAM - SCHOOL OF OPTOMETRY
Secondary Phone
7702778554
Graduation Year
2018 (8 years ago)
PAC ID
4284960170
Group Practice PAC ID
7810893732
Professional Enrollment ID
I20190730004591
Address ID
GA300463395LA748XXRDXX402

Contacts

Other Endpoint
None
Other Endpoint
Home
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:6State licenses:1Other namesUpdated within 12 months

9,658 NURSE PRACTITIONER in GA

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Provider Addresses for JACQUELINE SMALL

  • 3910 PLANTATION MILL DR

    BUFORD, GA 305191970

    Phone: (770) 314-8027

    Type: Mailing

  • West Maple Street, Cumming, Forsyth County, Georgia, 30040, United States

    CUMMING, GA 30040

    Phone: (770) 888-6697

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 206 Open Payments records for all available years, with a total value of $4,058.

Total Amount is formed as General ($4,058) + Research ($0) + Ownership ($0) = $4,058.

Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Lilly USA, LLC ($508).

Total Amount

$4,058

General + Research + Ownership

Payments

206

Total payment records

General Amount

$4,058

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2019-07-30

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190730004591INurse PractitionerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes469355$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit188188$0
J1100Injection, dexamethasone sodium phosphate, 1 mg10022$0
96372Injection of drug or substance under skin or into muscle3027$0
J1030Injection, methylprednisolone acetate, 40 mg2522$0
View full utilization report →

Insurance plans in this area (ZIP 30519)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7810893732View full group profile

Reviews

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Frequently asked questions

Does JACQUELINE SMALL share an NPI with anyone else?
NPI numbers are unique to each provider or organization — JACQUELINE SMALL uses 1407415615.
Is JACQUELINE SMALL still practicing?
JACQUELINE SMALL is currently listed as active in the public NPI registry.
What taxonomy line describes JACQUELINE SMALL?
For research purposes, treat JACQUELINE SMALL as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does JACQUELINE SMALL serve?
JACQUELINE SMALL's listing highlights Buford, Georgia; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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