Kendra Jackson, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1351 Newtown Pike BLDG 1
Lexington, KY 40511-1277

Phone

(859) 253-1686

NPI assigned

Feb 8, 2022

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Vista of the Bluegrass IncGroup PAC ID 6608773619, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• New Vista of the Bluegrass Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frankfort, KY
  • NPI 1790731081
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1851045983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE BLDG 1",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE BLDG 1",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111277",
            "telephone_number": "859-253-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KENDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaela Jackson, RDN
• Karrington I Jackson
• Kathleen Patterson Jackson, LCSW
• Katlyn Davis Jackson, M.ED, BCBA
• Keiarra Jackson, RN
• Larry Jackson Jr.
• Lloyd Dallas Jackson, L.C.S.W.
• Madison Taylor Jackson
• Marie R. Jackson, CRNA
• Megan Grace Jackson, DMD

• Social Worker in Lexington, KY
• Providers in Lexington, KY by specialty
• Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.