Mrs Carroll Davis Jackson, APRN in Adel, GA - Medicare Nurse Practitioner

Mrs Carroll Davis Jackson, APRN is a medicare enrolled "Nurse Practitioner - Family" in Adel, Georgia. She graduated from nursing school in 2017 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Tift Regional Health System Inc and her current practice location is 172 Mj Taylor Rd, Adel, Georgia. You can reach out to her office (for appointments etc.) via phone at (229) 896-8500.

Mrs Carroll Davis Jackson is licensed to practice in Georgia (license number NP167907) 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 1982111704.

Contact Information

	Mrs Carroll Davis Jackson, APRN
	172 Mj Taylor Rd, Adel, GA 31620-3497
	(229) 896-8500
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Carroll Davis Jackson
Gender	Female
Speciality	Nurse Practitioner
Experience	9 Years
Location	172 Mj Taylor Rd, Adel, Georgia
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Carroll Davis Jackson graduated from nursing school in 2017

NPI Data:

NPI Number: 1982111704
Provider Enumeration Date: 01/02/2018
Last Update Date: 10/13/2025

Medicare PECOS Information:

PECOS PAC ID: 0547698508
Enrollment ID: I20200325002168

Medical Identifiers

Medical identifiers for Mrs Carroll Davis Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1982111704	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	NP167907 (Georgia)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Cook Medical Center A Campus Of Tift Reg Med Ctr	Adel, GA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Tift Regional Health System Inc	2062745169	262

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. Mrs Carroll Davis Jackson allows following entities to bill medicare on her behalf.

Entity Name	Tift Regional Health System Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881203305 PECOS PAC ID: 2062745169 Enrollment ID: O20200217002409

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. Mrs Carroll Davis 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 Address	Practice Location Address
Mrs Carroll Davis Jackson, APRN 907 18th St E Ste 400, Tifton, GA 31794-3684 Ph: (229) 353-3422	Mrs Carroll Davis Jackson, APRN 172 Mj Taylor Rd, Adel, GA 31620-3497 Ph: (229) 896-8500

Reviews and Comments

Nurse Practitioner Nurses in Adel, GA

Alexander Warren, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 110 S Hutchinson Ave, Adel, GA 31620 Phone: 229-896-2124
Mrs. Priscilla R Greene, FHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 172 Mj Taylor Rd, Adel, GA 31620 Phone: 229-896-5200 Fax: 229-388-9855
Walter Stone, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 172 Mj Taylor Rd, Adel, GA 31620 Phone: 229-896-8500
Tammy Charlene Carter, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 602 N Hutchinson Ave, Adel, GA 31620 Phone: 229-848-5073
Melissa Michelle Roberts, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 172 Mj Taylor Rd, Adel, GA 31620 Phone: 229-896-3424
David K. Vickers, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 103 James St, Adel, GA 31620 Phone: 229-896-3424 Fax: 229-896-3838
Caroline Hendley, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 172 Mj Taylor Rd, Adel, GA 31620 Phone: 229-896-8500

Mrs Carroll Davis Jackson, APRN - Medicare Nurse Practitioner in Adel, GA