Active NPI
Cristy Jackson, PA-C
- Physician Assistant
- Lexington, KY
National Provider Identifier
1780853655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA810
- Practice address
- 161 N Eagle Creek Dr
Ste 400
Lexington, KY 40509-9038 - Phone
- (859) 226-0031
- Fax
- (859) 226-0041
- NPI assigned
- Feb 26, 2008
- Last updated
- Jul 23, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA810 | KY | Primary |
Addresses
Primary practice location
161 N Eagle Creek Dr
Ste 400
Lexington, KY 40509-9038
Mailing address
161 N Eagle Creek Dr
Ste 400
Lexington, KY 40509-9038
Phone (859) 226-0031
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100042780 | Medicaid | KY | |
| 1060002 | Other | KY | NCCPA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA810 | KY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keightley & Parsley P S C | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 1
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 Emergency Physicians Lexington
- Emergency Medicine Physician
- Lexington, KY
- NPI 1386670503
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406073600000",
"number": "1780853655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 N EAGLE CREEK DR",
"address_2": "STE 400",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405099038",
"telephone_number": "859-226-0031",
"fax_number": "859-226-0041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 N EAGLE CREEK DR",
"address_2": "STE 400",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405099038",
"telephone_number": "859-226-0031",
"fax_number": "859-226-0041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CRISTY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-26",
"last_updated": "2014-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA810",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100042780",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCCPA",
"identifier": "1060002",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.