Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Nicole Etta Jackson, DO

Individual provider Family Medicine Physician · NPI 1578084927

Dr. Nicole Etta Jackson, DO is a Family Practice in Augusta, Georgia. Qualified in 2017, 9 years ago. Practices with Legacy Healthcare Services Inc, a 3,624-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
9
Licensed in
GA
In the registry since
2017
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1120 15th St
Augusta, GA 30912-0004
Phone: (706) 721-7005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 009754 (GA)

Record details

NPI number1578084927
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 6, 2017
Last updated in NPPESJuly 6, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Legacy Healthcare Services Inc — 3624 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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