Kerra Jones Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12328 Issued in NC

Practice address

3515 W Market St Ste 200
Greensboro, NC 27403-4442

Phone

(336) 660-5520

Fax

(336) 660-5539

NPI assigned

Jul 1, 2022

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

Electronic endpoints 1

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjackson739073@direct.conehealth.com
• Direct secure messaging: kjackson1077982@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group
• The Moses H Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1356372064

  Physician Assistant

  Medicare reassignment NPD
• NH Digital Health Services, LLC

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1427683044
  Medicare reassignment
• NH Digital Health Services, LLC

  • Hematology & Oncology Physician
  • Winston Salem, NC
  • NPI 1386506855
  NPD
• NH Digital Health Services, LLC

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1942172671
  NPD
• Novant Health Medical Group, LLC

  • Neurology Physician
  • Winston Salem, NC
  • NPI 1043713910
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Community/Retail Pharmacy
  • Eden, NC
  • NPI 1861222507
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1588397152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 W MARKET ST STE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274034442",
            "telephone_number": "336-660-5520",
            "fax_number": "336-660-5539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Elm St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011004",
            "country_code": "US",
            "telephone_number": "336-832-8064",
            "fax_number": "336-832-7893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KERRA",
        "middle_name": "JONES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjackson739073@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1200 N Elm St",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274011004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Freeman R Jackson Jr., M.D.
• Freeman Randolph Jackson, M.D.
• Jerica Jackson
• Julie Jackson, SLP
• Karla Jackson, LCMHC
• Kimberly Hamilton Jackson, M.A. LPC
• Kyle E. Jackson, MD
• Lily Diana Jackson, RN
• Michelle Jackson, FNP-BC
• Miya Jackson

• Physician Assistant in Greensboro, NC
• Providers in Greensboro, 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 4, 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.