Dr Nicole Etta Jackson, DO - Medicare Family Practice in Augusta, GA

  1. Home
  2. Family Medicine
  3. GA
  4. Augusta
Dr Nicole Etta Jackson, DO is a medicare enrolled "Family Medicine" physician in Augusta, Georgia. She graduated from medical school in 2017 and has 8 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Legacy Healthcare Services Inc, Fhpg Llc and her current practice location is 1120 15th St, Augusta, Georgia. You can reach out to her office (for appointments etc.) via phone at (706) 721-7005.

Dr Nicole Etta Jackson is licensed to practice in Georgia (license number 009754) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1578084927.

Contact Information

Dr Nicole Etta Jackson, DO
1120 15th St,
Augusta, GA 30912-0004
(706) 721-7005
Not Available

Map and Direction




Physician's Profile

Full NameDr Nicole Etta Jackson
GenderFemale
SpecialityFamily Practice
Experience8 Years
Location1120 15th St, Augusta, Georgia
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Nicole Etta Jackson graduated from medical school in 2017
  NPI Data:
  • NPI Number: 1578084927
  • Provider Enumeration Date: 07/06/2017
  • Last Update Date: 07/06/2017
  Medicare PECOS Information:
  • PECOS PAC ID: 6800162603
  • Enrollment ID: I20201008000670

Medical Identifiers

Medical identifiers for Dr Nicole Etta Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1578084927NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 009754 (Georgia)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Firsthealth Home CareWest end, NCHome health agency
Firsthealth Moore Regional HospitalPinehurst, NCHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Legacy Healthcare Services Inc21633397223474
Fhpg Llc9537481569169

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Nicole Etta Jackson allows following entities to bill medicare on her behalf.
Entity NameFirsthealth Of The Carolinas Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548276389
PECOS PAC ID: 8820909377
Enrollment ID: O20031108000016
Entity NameMcpc-2 Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962737452
PECOS PAC ID: 1254473630
Enrollment ID: O20100122000627
Entity NameMcpc-7 Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1881968709
PECOS PAC ID: 9739341066
Enrollment ID: O20120503000387
Entity NameMcpc-8 Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922552322
PECOS PAC ID: 3870740012
Enrollment ID: O20120823000423
Entity NameMcpc-16 Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114351095
PECOS PAC ID: 4082841465
Enrollment ID: O20131210000462
Entity NameFhpg Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336154129
PECOS PAC ID: 9537481569
Enrollment ID: O20141202002644
Entity NameMcpc-17 Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518312073
PECOS PAC ID: 5395030159
Enrollment ID: O20160818002018

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Nicole Etta Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Nicole Etta Jackson, DO
269 W Vineland Rd,
Augusta, GA 30904-3418

Ph: (715) 828-2284		Dr Nicole Etta Jackson, DO
1120 15th St,
Augusta, GA 30912-0004

Ph: (706) 721-7005

Reviews and Comments


Family Medicine Doctors in Augusta, GA

Dr. Toya Hester Kelley, MD
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 1120 15th St, Augusta, GA 30912
Phone: 706-721-3157    
Janis S. Coffin, DO
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 1120 15th St, Augusta, GA 30912
Phone: 706-721-4588    Fax: 706-721-7264
Dr. Thomas Christopher Smith, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1701 Magnolia Way Ste 101, Augusta, GA 30909
Phone: 706-922-6600    Fax: 706-650-0239
Dr. William Robert Rout, M.D.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 963 Bennock Mill Dr., Augusta, GA 30906
Phone: 352-538-5899    
Angela Overstreet Wright, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2607 Commons Blvd, Augusta, GA 30909
Phone: 706-750-8601    
Shahed Anam Ibn Faruk,
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 1120 15th St, Augusta, GA 30912
Phone: 706-721-2273    
Mark David Beckman, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1120 15th St, Augusta, GA 30912
Phone: 706-721-3157    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.