Morgan Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9117269 Issued in FL

Practice address

695 Cone Park CT
Merritt Island, FL 32952-3755

Phone

(321) 453-3360

NPI assigned

Apr 3, 2019

Last updated

Oct 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC, FL3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brevard Medical Dermatology, PAGroup PAC ID 4688999345, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjackson140416@direct.carilionclinic.org

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.

• Brevard Medical Dermatology, PA

  • Dermatology Physician
  • Melbourne, FL
  • NPI 1649676669
  Medicare reassignment Care Compare group
• Carilion Medical Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1730123472

  Single Specialty

  Medicare reassignment NPD
• Carilion Healthcare Corporation

  dba Bridgewater College Student Health Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1447206370
  Medicare reassignment
• Physical Medicine Associates, LTD

  dba National Spine & Pain Centers

  • Interventional Pain Medicine Physician
  • McLean, VA
  • NPI 1003884560

  DC

  Medicare reassignment
• Carilion Healthcare Corporation

  • Durable Medical Equipment & Medical Supplies
  • Blacksburg, VA
  • NPI 1407667256
  NPD
• Carilion Medical Center

  dba Carilion Clinic - DME - Westlake

  • Durable Medical Equipment & Medical Supplies
  • Hardy, VA
  • NPI 1073324810
  NPD
• Space Coast Dermatology Clinic, PLLC

  • Clinic/Center
  • Merritt Island, FL
  • NPI 1043423189

  Single Specialty

  NPD (past)
• Physical Medicine Associates LTD

  • Clinical Laboratory Director (Non-physician)
  • Columbia, MD
  • NPI 1750840666

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1073075453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD",
            "address_2": "EXECUTIVE PLAZA 1, STE. 501",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "21031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 CONE PARK CT",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523755",
            "telephone_number": "321-453-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MORGAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007501",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Island Weight Loss
• Island Weight Loss
• Izak, LLC (Avid Home Care Services)
• Cheryl Jacobs
• Mary Jacobsen, LPN
• Jahbless Phlebotomy Services LLC
• Marla Jean James, OTR/L
• Monica James

• Physician Assistant in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.