Kina Ladawn Jackson, AGNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5009255 Issued in NC

Practice address

1904 Jake Alexander Blvd W Ste 301
Salisbury, NC 28147-1177

Phone

(336) 718-7500

NPI assigned

Jan 21, 2017

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: kjackson161291@direct.novanthealth.org

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

{
    "created_epoch": "1484956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1649717232",
    "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": "1904 JAKE ALEXANDER BLVD W STE 301",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281471177",
            "telephone_number": "336-718-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Brenner Ave",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281442515",
            "country_code": "US",
            "telephone_number": "704-638-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4610 Country Club Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271043520",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Westgate Center Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033104",
            "country_code": "US",
            "telephone_number": "336-718-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KINA",
        "middle_name": "LADAWN",
        "name_prefix": "Ms.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-21",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009255",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "208785",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iwin, LLC
• J David Boyd DDS PA
• J N Holmes MD and Associates General Internal Medicine PLLC
• J. Stephen Selden DDS and Associates, PA
• Felicia Maria Jabs, MA, BCBA, LBA
• Joseph Elmer Jacobson, MD
• Alex Jadidian, PH.D.
• Kiran K Jagarlamudi, M.D.
• Prachee Jain, M.D.
• Beverly Ann Jalbert, RRT/RCP

• Nurse Practitioner in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.