Jackson Roberson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-15256 Issued in NC

Practice address

501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211-0035

Phone

(704) 377-2424

Fax

(704) 377-2687

NPI assigned

Jun 14, 2024

Sex

Male

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 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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1760950646
  Medicare reassignment Care Compare group
• Mid-Atlantic Emergency Medical Associates, PLLC

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1073562757
  Medicare reassignment
• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Asheville, NC
  • NPI 1235014796
  NPD
• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Huntersville, NC
  • NPI 1972488427
  NPD
• Mema SC LLC

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1407675176
  NPD
• Carolina Medicorp Enterprises Inc

  • Pediatrics Physician
  • Charlotte, NC
  • NPI 1417497504
  NPD (past)

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1821831223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S SHARON AMITY RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110035",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S SHARON AMITY RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110035",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13129 S Tryon St Ste 120",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282787915",
            "country_code": "US",
            "telephone_number": "980-337-4662",
            "fax_number": "980-337-4658",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Hawthorne Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042515",
            "country_code": "US",
            "telephone_number": "704-384-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "JACKSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-14",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily A Robbins, LCSW
• Joy Pearson Robbins, LPC
• Lafewanda Anittra Robbins
• Diana Roberson
• Genesy Roberson
• Kelly Renee Roberson, MA, LCMHCA
• Lewis Harvey Roberson II, MD
• Patrice Roberson
• Robin Roberson
• Robert a Green PHD and Associates PA

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, 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 Dec 5, 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.