Trevis Shantell Jackson
Physical Medicine & Rehabilitation Physician · Fairburn, GA
Trevis Shantell Jackson is a physical medicine & rehabilitation physician with a practice address in Fairburn, Georgia, and NPI 1073321659, issued on Dec 27, 2024. Check the license (Georgia OTA000749, as entered in NPPES) on the Georgia Composite Medical Board; the federal record below is the public data PlainDoctor holds for this provider.
- Name
- Trevis Shantell Jackson
- Primary taxonomy
- Physical Medicine & Rehabilitation Physician 208100000X
- License number
- OTA000749 GA
Self-reported in NPPES; status is on the state search - Practice location
- 7420 Mistydawn Dr, Fairburn, GA 30213
- Phone
- (678) 361-8944
- Enumerated
- Dec 27, 2024
- Record last updated
- Dec 27, 2024
- Entity
- Type 1 · individual
8 nearest physical medicine & rehabilitation physician records → All 317 in Georgia → Look up another NPI →
Verify Trevis Shantell Jackson in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersGeorgia Composite Medical Board
Search for license OTA000749Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Trevis Shantell Jackson among 317 physical medicine & rehabilitation physician records in Georgia
Trevis Shantell Jackson is one of 317 physical medicine & rehabilitation physician records with a practice address in Georgia. 67% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does not. Its NPI, issued in 2024, is newer than 94% of them.
- NPI issued2024 · 94% of these records are older, 3% newer
- In a Medicare fileNo · 67% of these records are
- In the CMS Doctors and Clinicians fileNo · 59% of these records are
- Record last updated2024 · 52% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 208100000X and a Georgia practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
Physical Medicine & Rehabilitation Physician providers in Georgia
There are 317 physical medicine & rehabilitation physician records in Georgia. No Medicare prescribing, quality score, industry payment or hospital affiliation is published for this NPI.
All 317 in Georgia → Every provider in Fairburn → Physical Medicine & Rehabilitation Physician nationwide →
The 8 physical medicine & rehabilitation physician records with the nearest ZIP codes
- David Popoli, M.D.Fayetteville, GA 302141124293089
- Evan Reuter, MDFayetteville, GA 302141881221240
- Julie Levine, D.O.Woodstock, GA 301891265618946
- Jasmin Abrahamsen, PTWoodstock, GA 301881417747619
- Shelby Crane, PT, DPTWoodstock, GA 301881770319154
- Karin Taylor, MDLagrange, GA 302401366768459
- Anthony Cooper, DOMcDonough, GA 302531912434986
- Jyoti Gharge, MDMcDonough, GA 302531720015027
Common questions
What is Trevis Shantell Jackson's NPI number?
Trevis Shantell Jackson's National Provider Identifier (NPI) is 1073321659, issued on Dec 27, 2024. An NPI identifies a provider in billing; it is not a license.
Where is Trevis Shantell Jackson located?
The NPPES record lists a practice address at 7420 Mistydawn Dr, Fairburn, GA, 30213. Phone: (678) 361-8944. Providers update this record themselves, so call before visiting.
How can I verify Trevis Shantell Jackson's license?
NPPES lists Georgia license number OTA000749, as entered by the provider. Search the Georgia Composite Medical Board at https://medicalboard.georgia.gov/. The NPPES record confirms identity only; the state search shows license status, expiration and public orders.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.