Holly M Jackson (NPI# 1427576511, PAC ID# 8123384989) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1427576511 |
| PAC ID by PECOS | 8123384989 |
| Professional Enrollment ID | I20171110000478 |
| Full Name | Holly M Jackson |
| Organization Legal Name | TANNER MEDICAL GROUP INC |
| Address |
905 Dixie St Carrollton GA 30117-4417 |
| Phone Number | 7708125831 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2769536143 |
| Number of Group Practice Members | 65 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110011 | TANNER MEDICAL CENTER - CARROLLTON |
| 111320 | HIGGINS GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 905 Dixie St, Carrollton, GA 30117-4417 | 7708125831 | TANNER MEDICAL GROUP INC |
| Organization Legal Name | TANNER MEDICAL GROUP INC |
| Physicians | 69 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Austin J Lewis | General Surgery | Tanner Medical Group Inc | 157 Clinic Ave, Suite 302, Carrollton, GA 30117-4454 |
| Ruth Anne Farrell | Obstetrics/gynecology | Tanner Medical Group Inc | 109 Professional Pl, Carrollton, GA 30117-3862 |
| Emily H Turney | Obstetrics/gynecology | Tanner Medical Group Inc | 150 Henry Burson Ave, Suite 215, Carrollton, GA 30117-4466 |
| Stephen Housman Kahler | Plastic and Reconstructive Surgery | Tanner Medical Group Inc | 119 Ambulance Dr, Suite 202, Carrollton, GA 30117-3818 |
| David G Helton | Obstetrics/gynecology | Tanner Medical Group Inc | 706 Dixie St, Suite 200, Carrollton, GA 30117-3819 |
| David W Griffin | General Surgery | Tanner Medical Group Inc | 204 Allen Memorial Dr, Suite 101, Bremen, GA 30110-2063 |
| James R Bland Iii | Radiation Oncology | Tanner Medical Group Inc | 165 Clinic Ave, Carrollton, GA 30117-4413 |
| Kenneth L Boss | Family Medicine | Tanner Medical Group Inc | 705 Dallas Hwy, Suite 101, Villa Rica, GA 30180-1243 |
| Alexander Mayer | Cardiovascular Disease (cardiology) | Tanner Medical Group Inc | 157 Clinic Ave, Carrollton, GA 30117-4454 |
| Ronda S Phillips | Nurse Practitioner | Tanner Medical Group Inc | 119 Ambulance Dr, Suite 202, Carrollton, GA 30117-3818 |
| Street Address |
905 DIXIE ST |
| City | CARROLLTON |
| State | GA |
| Zip | 30117-4417 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Angela Pham | Rheumatology | Tanner Medical Group Inc | 905 Dixie St, Carrollton, GA 30117-4417 |
| Cristal Ann Rush | Nurse Practitioner | Tanner Medical Group Inc | 905 Dixie St, Carrollton, GA 30117-4417 |
| Emily M Rooks | Family Medicine | Tanner Medical Group Inc | 905 Dixie St, Carrollton, GA 30117-4417 |
| Yelena R Makori | Internal Medicine | Tanner Medical Group Inc | 905 Dixie St, Carrollton, GA 30117-4417 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hermogenes B Pagsisihan | Family Medicine | Primary Care Group of West Georgia | 100 Professional Park, Suite 204, Carrollton, GA 30117 |
| Lindsey B Roenigk | Critical Care (intensivists) | Primary Care Group of West Georgia | 100 Professional Park, Suite 204, Carrollton, GA 30117 |
| Lauren Holcombe | Nurse Practitioner | Primary Care Group of West Georgia | 100 Professional Park, Suite 204, Carrollton, GA 30117 |
| Savannah Bryanna Jackson | Nurse Practitioner | Primary Care Group of West Georgia | 100 Professional Park, Suite 204, Carrollton, GA 30117 |
| Jeffrey S Reid | Internal Medicine | Primary Care Group of West Georgia | 100 Professional Park, Suite 204, Carrollton, GA 30117 |
| Joseph M Jellicorse | Family Medicine | Primary Care Group of West Georgia | 100 Professional Park, Suite 204, Carrollton, GA 30117 |
| Elizabeth K Scholl | Physician Assistant | Primary Care Group of West Georgia | 100 Professional Park, Suite 204, Carrollton, GA 30117 |
| Mandi C Fowler | Physician Assistant | Primary Care Group of West Georgia | 100 Professional Park, Carrollton, GA 30117 |
| James C Huff | Optometry | 702 Bankhead Hwy, Carrollton, GA 30117-1962 | |
| James Charnitski | Chiropractic | 1223 N Park St, Carrollton, GA 30117-2261 | |
| Find all physicians in zip 30117 | |||
| City | CARROLLTON |
| Zip Code | 30117 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | CARROLLTON + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Holly M Jackson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.