Kristin Jackson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

16337 Everhart Dr
Weed, CA 96094-9400

Phone

(530) 938-2297

NPI assigned

Jan 25, 2024

Last updated

Oct 21, 2026By 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

Enrolled in CA

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

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.

• Dignity Health

  dba Mercy Lake Shastina Community Clinic

  • Rural Health Clinic/Center
  • Weed, CA
  • NPI 1255609699
  NPD (past)
• Dignity Health

  dba Mercy Mt. Shasta Community Clinic

  • Rural Health Clinic/Center
  • Mount Shasta, CA
  • NPI 1568799500
  NPD (past)

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792540800000",
    "number": "1689436636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16337 EVERHARD DR",
            "city": "WEED",
            "state": "CA",
            "postal_code": "96094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16337 EVERHART DR",
            "city": "WEED",
            "state": "CA",
            "postal_code": "960949400",
            "telephone_number": "530-938-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KRISTIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-25",
        "last_updated": "2026-10-21",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heal Experiential LLC
• Health Quest Physical Therapy & Fitness Center, Inc.
• Monica Highfill
• Rebekah Hopkins, APCC
• J.T.O. Enterprises LLC.
• Donnetta Leann Kinney
• Joshua Kure, PA-C
• Lake Shastina Medical Clinic Inc
• Jenna Lynn Henson Marshall
• Theresa Anne Maurer, CPM

• Physician Assistant in Weed, CA
• Providers in Weed, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2026; 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.