Randy Jackson, PA
NPI 1629010707 · Medical Physician Assistant · Gainesville, GA
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Randy Jackson, PA is a Medical Physician Assistant provider in Gainesville, GA (NPI 1629010707).
Provider details
- NPI number
- 1629010707
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- 002048 (GA)
Specialties & taxonomies
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
20 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
- 2006-06-12
- Last updated
- 2007-11-07
Frequently asked questions
- What is Randy Jackson's NPI number?
- Randy Jackson's National Provider Identifier (NPI) is 1629010707, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Randy Jackson's specialty?
- Randy Jackson is listed in the NPPES registry with a primary specialty of Medical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Randy Jackson located?
- Randy Jackson's practice location on file with NPPES is 743 Spring St Ne, Gainesville, GA 30501-3715.
- What is Randy Jackson's phone number?
- The practice phone number listed in the NPPES registry for Randy Jackson is (770) 536-2146.
- Does Randy Jackson accept Medicare?
- Randy Jackson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Randy Jackson's NPI active?
- Yes — Randy Jackson's NPI (1629010707) is active in the NPPES registry as of the last update on 2007-11-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.