Kellontreia Jackson, A-GNP-C
NPI 1619685534 · Gerontology Nurse Practitioner · Hawkinsville, GA
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kellontreia Jackson, A-GNP-C is a Gerontology Nurse Practitioner provider in Hawkinsville, GA (NPI 1619685534).
Provider details
- NPI number
- 1619685534
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- A-GNP-C
- Sex
- Female
- Sole proprietor
- No
- License
- 4704420181 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-11-09
- Last updated
- 2026-05-13
- Certified
- 2026-05-13
Frequently asked questions
- What is Kellontreia Jackson's NPI number?
- Kellontreia Jackson's National Provider Identifier (NPI) is 1619685534, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kellontreia Jackson's specialty?
- Kellontreia Jackson is listed in the NPPES registry with a primary specialty of Gerontology Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Kellontreia Jackson located?
- Kellontreia Jackson's practice location on file with NPPES is 37 341 Byp, Hawkinsville, GA 31036-4839.
- What is Kellontreia Jackson's phone number?
- The practice phone number listed in the NPPES registry for Kellontreia Jackson is (478) 845-4842.
- Does Kellontreia Jackson accept Medicare?
- Kellontreia Jackson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kellontreia Jackson's NPI active?
- Yes — Kellontreia Jackson's NPI (1619685534) is active in the NPPES registry as of the last update on 2026-05-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.