Look up the most recent NPI and PECOS records

Bridgitte L. Jackson

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

6300 Hospital Pkwy Ste 300, Johns Creek, GA 30097-1982

PECOS Enrollment

This provider is enrolled in PECOS as BRIDGITTE JACKSON.

Based on the most recent information from CMS, provider Bridgitte L. Jackson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 9:24 AM.

Profile Details

Provider ID
1770643876
Provider Type
Individual
Full Name
Jackson, Bridgitte L.
Title
Ms.
Credential
FNP, AOCN

Gender
Female
Sole Proprietor
No
Enumeration Date
12/11/2006
Last Updated
4/6/2023

Contact Information

Practice Location

6300 Hospital Pkwy Ste 300, Johns Creek, GA 30097-1982

(770) 623-8965

(770) 623-4018

Mailing Location

1835 Savoy Dr Ste 300, Atlanta, GA 30341-1071

(678) 288-9555

(678) 288-9556

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License RN095124 NP Georgia

Provider Identifiers

ID	Description	Issuer
ID 000809487AE	Description Medicaid	Issuer Unlisted Georgia

Bridgitte L. Jackson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Johnson, Morgan Leigh Richburg

Kim, Reo Jin

Lee, Julie Choe

Park, Hanna Lee

Mcpherson, Danah Carla

Park, Minhee

An, Sung Hee

Stage, Monique Jennifer

Piecoro, Anna

Cason, Ashley Renee