NPI age
20 years
Enumerated 2005-11-02
● Active
Type 1 · Individual
MR. Ellis R Jackson, CRNA
Jackson is 1 of 142 nurse anesthetist, certified registered providers in MacOn and 1 of 2157 in Georgia.
Primary specialty
Nurse Anesthetist, Certified Registered
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2017-04-12
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 2157 active nurse anesthetist, certified registered providers in Georgia.
NPI age
20 years
↑ 5 yr above median (15 yr)
State licenses
1 state
15% of peers hold multiple states
Subspecialties
0
27% of peers hold subspecialties
NPI lifetime · 2005 → 2026
2005-11Enumerated in NPPES
2005
2026
Where they practice
Practice location
610 3rd St
MacOn, GA 312013294
Mailing address
427 Fussell Rd
Leesburg, GA 317635210
Specialties
-
Nurse Anesthetist, Certified Registered Primary(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 334081730A | |
| 01 (GA) | P00220709 | RR MEDICARE |
Practice context
Part of a multi-provider practice. 16 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- 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.