Jennifer Lauren Jackson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4880 Issued in TN

Practice address

2004 Hayes St Ste 200
Nashville, TN 37203-2689

Phone

(615) 324-1600

Fax

(615) 324-1661

NPI assigned

Feb 14, 2021

Sex

Female

Sole proprietor

Yes

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 TN

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Elite Sports Medicine and Orthopaedic Center PLCGroup PAC ID 8729009634, 90 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tristar Centennial Medical Center Hospital, Nashville, TN, CCN 440161
• Ascension Saint Thomas Hospital Hospital, Nashville, TN, CCN 440082

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.

• Elite Sports Medicine and Orthopaedic Center, PLC

  • Specialist
  • Nashville, TN
  • NPI 1528281623
  Medicare reassignment Care Compare group
• Elite Sports Medicine and Orthopaedic Center, PLC

  • Orthopaedic Surgery Physician
  • Brentwood, TN
  • NPI 1669115622
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HCA Health Services of Tennessee, Inc.

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1023055126
  Care Compare affiliation
• Saint Thomas West Hospital

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1629025648
  Care Compare affiliation

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

{
    "created_epoch": "1613260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1952994626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 HAYES ST",
            "address_2": "STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032689",
            "telephone_number": "615-324-1600",
            "fax_number": "615-324-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 HAYES ST STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032689",
            "telephone_number": "615-324-1600",
            "fax_number": "615-324-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JENNIFER",
        "middle_name": "LAUREN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-14",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Jane Jackson, FNP-BC
• Jacques Leo Jackson, D.PH.
• James Jackson, PSYD
• Janice Jackson
• Jarrett Michael Jackson, MD
• Jesse Lafranza Jackson
• Jessica Meagan Jackson, COA
• John A Jackson, MD
• Katherine Danielle Jackson, APN
• Kayla Jackson, MD

• Physician Assistant in Nashville, TN
• Providers in Nashville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.