Individual provider Active NPI

Jamie Crystal Jackson, M.D.

  • Pediatrics Physician
  • Pensacola, FL
National Provider Identifier
1033389879
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
121872 Issued in FL
Practice address
5375 N 9TH Ave
Pensacola, FL 32504-8725
Phone
(850) 941-7841
Fax
(850) 332-0155
NPI assigned
Mar 7, 2008
Last updated
Jun 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 121872 FL Primary
Child Abuse Pediatrics Physician 2080C0008X 121872 FL

Addresses

Primary practice location

5375 N 9TH Ave
Pensacola, FL 32504-8725

Mailing address

2315 W Jackson St
Pensacola, FL 32505-7552
Phone (850) 941-7841

Other identifiers 1

IdentifierTypeStateIssuer
023386100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180213001242 FL Practitioner - Pediatric Medicine 6507058294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
121872FLMDPediatrics Physician
MD.203018LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Current Accepting new patients
Escambia Community Clinics Inc Current Accepting new patients
Children's Hospital Pediatrics Past Accepting new patients
Escambia Community Clinics, Inc Past Accepting new patients

Locations

6671 Caroline St
Milton, FL 32570
Phone (850) 564-7722

4435 Highway 90
Pace, FL 32571
Phone (850) 304-0390

1675 Trinity Dr
Pensacola, FL 32504
Phone (850) 416-1575

2315 W Jackson St
Pensacola, FL 32505
Phone (850) 495-3955

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1033389879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 W JACKSON ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325057552",
            "telephone_number": "850-941-7841",
            "fax_number": "850-332-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5375 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048725",
            "telephone_number": "850-941-7841",
            "fax_number": "850-332-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JAMIE",
        "middle_name": "CRYSTAL",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "121872",
            "primary": true
        },
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "FL",
            "license": "121872",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023386100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.