Active NPI
Shayla Jackson, PA-C
- Physician Assistant
- Mars, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA055773
- Practice address
- 6998 Crider Rd
Mars, PA 16046 - Phone
- (724) 778-3627
- NPI assigned
- Sep 25, 2012
- Last updated
- May 19, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085-011019 | IL | |
| Physician Assistant | 363A00000X | MA055773 | PA | Primary |
| Medical Physician Assistant | 363AM0700X | MA055773 | PA |
Addresses
Primary practice location
6998 Crider Rd
Mars, PA 16046
Mailing address
5200 Centre Ave Ste 715
Pittsburgh, PA 15232-1327
Other practice location 1
5200 Centre Ave Ste 715
Pittsburgh, PA 15232-1327
Phone (412) 864-7521
Other practice location 2
14555 W National Ave
New Berlin, WI 53151-4494
Phone (262) 693-4312
Other practice location 3
1441 Branding Ave Ste 310
Downers Grove, IL 60515-5624
Phone (708) 634-0950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100316099 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sjackson425772@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, WI, IL, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
420 E 2ND Ave
Suite 103
Rome, GA 30161-3210
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085-011019 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Floyd Healthcare Management Inc | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Floyd Healthcare Management Inc | Physician Assistant | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212
990 Veterans Memorial Hwy NE
#A
Rome, GA 30161
Phone (706) 291-4100
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
1441 Branding Ave
Ste 310
Downers Grove, IL 60515
Phone (630) 829-1038
1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791
14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650
5717 Albemarle Rd
Charlotte, NC 28212
Phone (704) 563-2150
9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
Interoperability endpoints
- sjackson425772@direct.myadvocateaurora.org
- sjackson905589@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 13
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.
-
dba Atrium Health Floyd Primary Care
- Family Medicine Physician
- Rome, GA
- NPI 1689610149
Physician Assistant
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
-
dba Advocate Medical Group
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
dba Atrium Health Urgent Care Arboretum
- Family Medicine Physician
- Charlotte, NC
- NPI 1457380313
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
dba Atrium Health Musculoskeletal Institute Orthopedics & Sports Medici
- Orthopaedic Surgery Physician
- Charlotte, NC
- NPI 1437607686
-
dba Advocate Children's Hospital
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
dba Atrium Health Allergy, Asthma & Immunology
- Allergy & Immunology Physician
- Charlotte, NC
- NPI 1215573423
-
dba Atrium Health Diabetes Prevention
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1437038544
-
dba Atrium Health Floyd Specialty Pharmacy
- Specialty Pharmacy
- Rome, GA
- NPI 1548056468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747612800000",
"number": "1679824064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 CENTRE AVE STE 715",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152321327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6998 CRIDER RD",
"city": "MARS",
"state": "PA",
"postal_code": "16046",
"telephone_number": "724-778-3627"
}
],
"practiceLocations": [
{
"address_1": "5200 Centre Ave Ste 715",
"address_purpose": "LOCATION",
"city": "Pittsburgh",
"state": "PA",
"postal_code": "152321327",
"country_code": "US",
"telephone_number": "412-864-7521",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14555 W National Ave",
"address_purpose": "LOCATION",
"city": "New Berlin",
"state": "WI",
"postal_code": "531514494",
"country_code": "US",
"telephone_number": "262-693-4312",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1441 Branding Ave Ste 310",
"address_purpose": "LOCATION",
"city": "Downers Grove",
"state": "IL",
"postal_code": "605155624",
"country_code": "US",
"telephone_number": "708-634-0950",
"fax_number": "708-634-0942",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "SHAYLA",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-25",
"last_updated": "2025-05-19",
"certification_date": "2025-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085-011019",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA055773",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA055773",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100316099",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sjackson425772@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1441 Branding Ave Ste 310",
"city": "Downers Grove",
"state": "IL",
"country_code": "US",
"postal_code": "605155624",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1441 Branding Ave Ste 310",
"city": "Downers Grove",
"state": "IL",
"country_code": "US",
"postal_code": "605155624",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mars, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.