Brooke A Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA797 Issued in KY

Practice address

2331 New Holt Rd
Paducah, KY 42001-7404

Phone

(270) 441-4777

Fax

(270) 441-4780

NPI assigned

Feb 5, 2007

Last updated

Jul 21, 2023By 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 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL, KY2 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 2

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

James Kyle Turnbo MD PSCGroup PAC ID 1557519600, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• James Kyle Turnbo M.D. PSC

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1457453540
  Medicare reassignment Care Compare group
• Southern Illinois Medical Services, NFP

  dba SIH Medical Group

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1770656837
  Medicare reassignment NPD
• West End Imaging, PLLC

  • Diagnostic Radiology Physician
  • Paducah, KY
  • NPI 1619559705
  NPD
• Healthworks Medical LLC

  • Interventional Pain Medicine Physician
  • Summerville, SC
  • NPI 1578954426
  NPD (past)
• Southern Illinois Hospital Services

  dba Sih Workready

  • Occupational Medicine Physician
  • Marion, IL
  • NPI 1104049766
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1508905662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 NEW HOLT RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017404",
            "telephone_number": "704-411-4777",
            "fax_number": "270-441-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 NEW HOLT RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017404",
            "telephone_number": "270-441-4777",
            "fax_number": "270-441-4780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 E Clark St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "IL",
            "postal_code": "629462702",
            "country_code": "US",
            "telephone_number": "618-252-8625",
            "fax_number": "618-252-2540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2808 Outer Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595207",
            "country_code": "US",
            "telephone_number": "618-993-3817",
            "fax_number": "618-993-3908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BROOKE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA797",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085 002103",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bjackson13982@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "117 E Clark St",
            "city": "Harrisburg",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629462702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bjackson13982@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2808 Outer Dr",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629595207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Victoria Ivanukoff, DO
• J Michael Giannini PSC (J Michael Giannini MD PSC)
• J.F. Wilson Wellness Center, LLC.
• Jackson Purchase ER Physicians, PSC
• Jackson Purchase Medical Associates, PSC
• Catherine Marie Jackson, DNAP, CRNA
• Deana K. Jackson, MOT, OTR/L
• Jonathan Jackson
• Karmen Jackson
• Lauren Holt Jackson, M.D.

• Physician Assistant in Paducah, KY
• Providers in Paducah, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.