Jennifer Michelle Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-15151 Issued in NC

Practice address

144 Poole Rd Ste 102
Leland, NC 28451-9504

Phone

(910) 641-8650

NPI assigned

Apr 22, 2024

Last updated

Feb 19, 2025By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbus Regional Health NetworkGroup PAC ID 6608924931, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Columbus Regional Healthcare System Hospital, Whiteville, NC, CCN 340068

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjackson2993360@carolinashealthcaresystem.direct-ci.com

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.

• Columbus Regional Health Network

  dba Advanced Family Care

  • Hospitalist Physician
  • Whiteville, NC
  • NPI 1508001009
  Medicare reassignment Care Compare group
• Columbus Regional Health Network

  dba Advanced Orthopedics

  • Orthopaedic Surgery Physician
  • Whiteville, NC
  • NPI 1790224962
  NPD
• Columbus Regional Health Network

  dba Advanced Urology

  • Urology Physician
  • Whiteville, NC
  • NPI 1801126479

  Single Specialty

  NPD
• Columbus Regional Health Network

  dba Advanced Primary Care

  • Family Medicine Physician
  • Whiteville, NC
  • NPI 1518263268

  Single Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbus Regional Healthcare System

  dba South Columbus Medical Clinic

  • General Acute Care Hospital
  • Whiteville, NC
  • NPI 1376537555
  Care Compare affiliation

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1114772308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 POOLE RD STE 102",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284519504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 POOLE RD STE 102",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284519504",
            "telephone_number": "910-641-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Intracoastal Dermatology and Skin Surgery PLLC
• Intracoastal Medical Solutions PLLC (Coastline Wellness)
• Frederick B Ireland, DPT
• Riley Elizabeth Isom, LCSWA
• Jackson Eye Associates, OD PA
• James a. Poe, D.D.S. and Associates, PLLC (DentalWorks)
• Cory Craven Jameson II, DMD
• Ania E Jarmulowicz, LCSW
• Lekeshia Williams Jarrett, MD
• Jeffrey Kozlowski DDS Leland PLLC (Campbell Covington and Icenhour)

• Physician Assistant in Leland, NC
• Providers in Leland, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.