Kennedy Jackson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1716 9TH Ave S
Birmingham, AL 35233-1124

Phone

(502) 759-6531

NPI assigned

Jun 14, 2023

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

Medicare fee-for-service enrollment

Enrolled in AL

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HH Physicians NetworkGroup PAC ID 6901132448, 107 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• HH Physicians Network

  • Specialist
  • Huntsville, AL
  • NPI 1891359683
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1205510658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 31ST ST S APT 301",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352052039",
            "telephone_number": "502-759-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 9TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331124",
            "telephone_number": "502-759-6531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KENNEDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerimesha Jackson, CRNP
• Jerry W Jackson, MD
• Jo Anne Jackson, DMD
• Juyoung Jackson, FNP-C
• Kaci Jackson
• Kim Jackson
• Kimberly Rae Ward Jackson, MD
• Kimberly S Jackson, RN
• Larry K Jackson, M.D.
• Lillie Jackson, PA

• Physician Assistant in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.