| NPI | 1033396841 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2008-01-23 |
| Last Updated | 2024-04-16 |
| Mailing Address | Po Box 12938, C/o Clinic Management Calhoun, GA 30703 United States Phone: (706) 602-7800 📍 View Map |
| Primary Practice Address | 2112 Shorter Ave Nw Ste 240 Rome, GA 30165-2042 United States Phone: (706) 368-8575 | Fax: (706) 204-9430 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 208000000X – Pediatrics | GA | 060642 |
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About NPI 1033396841
Bethany Wall Jackson M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1033396841. The primary specialty listed is Pediatrics. The provider is located in Rome, GA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2008-01-23. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1033396841?
NPI 1033396841 belongs to Bethany Wall Jackson M.D., a Pediatrics in Rome, GA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1033396841 active?
The current status of NPI 1033396841 in the NPPES registry is Active. The record was last updated on 2024-04-16.
What specialty is NPI 1033396841?
NPI 1033396841 is classified under the taxonomy Pediatrics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1033396841?
You can verify NPI 1033396841 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1033396841?
The primary practice address on file for NPI 1033396841 is 2112 Shorter Ave Nw Ste 240, Rome, GA 30165-2042. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1033396841 issued?
NPI 1033396841 was first issued (enumerated) on 2008-01-23. The NPPES record was last updated on 2024-04-16.
Practice Location Map
Bethany Wall Jackson is located at 2112 Shorter Ave Nw Ste 240, Rome, GA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Bethany Wall Jackson. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1033396841. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pediatrics | 060642 | GA |