NPI age
20 years
Enumerated 2006-05-06
● Active
Type 1 · Individual
DR. Avanelle V Jack, MD
Jack is 1 of 15 internal medicine providers in Brunswick and 1 of 562 in Georgia.
Primary specialty
Internal Medicine
Plus 1 subspecialty
Licensed in
GA, LA
2 states
Status
Active
No deactivations on record
Last NPPES update
2017-10-24
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 562 active internal medicine providers in Georgia.
NPI age
20 years
≈ at median (19 yr)
State licenses
2 states
Top 81% — 18% of peers are multi-state
Subspecialties
0
35% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-05Enumerated in NPPES
2006
2026
Where they practice
Practice location
208 Scranton Connector Ste 117
Brunswick, GA 315250560
Mailing address
208 Scranton Connector, Suite 117
Brunswick, GA 31525
Specialties
-
Internal Medicine PrimaryAn internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (LA) | 1491501 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 2 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.