NPI age
1 years
Enumerated 2024-12-27
● Active
Type 1 · Individual
Trevis Shantell Jackson
Jackson is 1 of 1 physical medicine & rehabilitation providers in Fairburn and 1 of 489 in Georgia.
Primary specialty
Physical Medicine & Rehabilitation
Plus 1 subspecialty
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2024-12-27
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 489 active physical medicine & rehabilitation providers in Georgia.
NPI age
1 years
↓ 13 yr below median (14 yr)
State licenses
1 state
12% of peers hold multiple states
Subspecialties
1
In the 31% of peers with subspecialties
NPI lifetime · 2024 → 2026
2024-12Enumerated in NPPES
2024
2026
Where they practice
Practice location
7420 Mistydawn Dr
Fairburn, GA 302134330
Mailing address
7420 Mistydawn Dr
Fairburn, GA 302134330
Specialties
-
Physical Medicine & Rehabilitation PrimaryPhysical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from...
-
Occupational Therapy AssistantAn occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.