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

Jasmine Nichole Jack, MD

Individual provider Psychiatry Physician · NPI 1437737392

Jasmine Nichole Jack, MD is a Psychiatry in Villa Rica, Georgia. Qualified in 2021, 5 years ago. Practices with Mass General Brigham Medical Group Suburban Massachusetts Inc, a 532-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
5
Licensed in
GA
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

20 Herrell Rd
Villa Rica, GA 30180-5527
Phone: (110) 812-3530
Fax: (770) 812-3531
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 113223 (GA)

Record details

NPI number1437737392
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 31, 2021
Last updated in NPPESJuly 17, 2026
Certification dateJuly 17, 2026

Medicare enrollment

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

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Mass General Brigham Medical Group Suburban Massachusetts Inc — 532 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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