Nina Katherine Trent Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1563 Issued in SC

Practice address

209 Patewood Dr Ste 200
Greenville, SC 29615-3589

Phone

(864) 522-6630

Fax

(864) 522-6635

NPI assigned

Sep 27, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Nina Katherine Trent Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: njackson6789@direct.ghs.myhfn.org

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

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment Care Compare group NPD (past)
• Privia Medical Group South Carolina, LLC

  • Otolaryngology Physician
  • Greenville, SC
  • NPI 1649875816
  Medicare reassignment
• Prisma Health University Medical Group

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Prisma Health University Medical Group

  • Pediatrics Physician
  • Taylors, SC
  • NPI 1801524392
  NPD

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1033428933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-695-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 PATEWOOD DR STE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153589",
            "telephone_number": "864-522-6630",
            "fax_number": "864-522-6635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Doctors Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054266",
            "country_code": "US",
            "telephone_number": "864-572-7001",
            "fax_number": "864-412-0436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "NINA",
        "middle_name": "KATHERINE TRENT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-27",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1081PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NINA",
            "last_name": "TRENT",
            "middle_name": "KATHERINE",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristen Staples Jackson, MCD
• Lauren Elizabeth Jackson, M.S., CCC-SLP
• Mark R Jackson, MD
• Marylee Jackson, PA
• Michelle Antonia Jackson
• Samuel Collins Jackson, DPT
• Tiffany Michelle Jackson, LPN
• Timothy G Jackson, MMFT, LMFT-A
• Tyla Jackson
• William Henry Jackson Jr., M.D., M.B.A

• Physician Assistant in Greenville, SC
• Providers in Greenville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.