ANCELLE MAE JACKSON (APRN) – Family Nurse Practitioner, NPI 1477027373
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,658 NURSE PRACTITIONER in GA
Provider Addresses for ANCELLE MAE JACKSON (APRN)
2620 ELM HILL PIKE
NASHVILLE, TN 372143108
Phone:
Type: Mailing
774 HIGHWAY 96
BONAIRE, GA 310053300
Phone: (478) 988-5711
Type: Location
4220 PLANTATION OAKS BLVD UNIT 1812
ORANGE PARK, FL 320653547
Phone: (904) 386-7374
Type: Mailing
1428 RIDGE BROOK TRL
DULUTH, GA 300966810
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $13.
Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.
Last reported payment date: 2024-03-12 • Largest payer in this snapshot: Phadia US Inc. ($13).
Total Amount
$13
General + Research + Ownership
Payments
1
Total payment records
General Amount
$13
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Phadia US Inc. | $13 |
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: 2021-06-07
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 |
|---|---|---|---|---|
| I20210607002359 | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 20 | 20 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 19 | 19 | $0 |
| G0008 | Administration of influenza virus vaccine | 17 | 17 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 37214)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | FL | |
| Nurse Practitioner | GA | |
| Internal Medicine | GA | |
| Nurse Practitioner | GA | |
| Family Practice | LA | |
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| Internal Medicine | VA | |
| Family Practice | GA |
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