Joann Kate Jackson, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001002237 Issued in NC

Practice address

1099 Medical Center Dr
Suite 201
Wilmington, NC 28401-7346

Phone

(910) 251-9944

Fax

(910) 763-4666

NPI assigned

Mar 1, 2010

Last updated

Nov 8, 2011By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Carolina Skin Care, PA

  • Dermatology Physician
  • Pinehurst, NC
  • NPI 1205999687
  NPD (past)
• Dermone of North Carolina PA

  • MOHS-Micrographic Surgery Physician
  • Wilmington, NC
  • NPI 1245578921
  NPD (past)
• Southern Dermatology, P.a.

  • Specialist
  • Raleigh, NC
  • NPI 1568415586
  NPD (past)

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

{
    "created_epoch": "1267401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1265755524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 MEDICAL CENTER DR",
            "address_2": "SUITE 201",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017346",
            "telephone_number": "910-251-9944",
            "fax_number": "910-763-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 MEDICAL CENTER DR",
            "address_2": "SUITE 201",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017346",
            "telephone_number": "910-251-9944",
            "fax_number": "910-763-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOANN",
        "middle_name": "KATE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-01",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001002237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Denise Jackson, LCSW, LCAS-A
• Cory Daniel Jackson
• Eric Michael Jackson, M.D.
• Jennifer Ann Jackson, LCSWA
• Jerry Edwin Jackson Jr., LPC
• Jonathan Floyd Jackson, O.D.
• Joseph Alan Jackson, LCMHCA
• Latoya Jackson, MS,QP
• Mary Louise Jackson, NP
• Naomi Namrota Jackson, PA-C

• Medical Physician Assistant in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.