KIMBERLY JACKSON
NPI 1083380125
Nurse Practitioner - Primary Care in Pittsburgh, PA
About Kimberly Jackson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMBERLY JACKSON (NPI 1083380125) is an individual primary care provider in Pittsburgh, Pennsylvania, licensed in Pennsylvania (SP024265) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kimberly Jackson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 15221 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PITTSBURGH, PA 15221
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kimberly Jackson's NPI number?
The NPI number for Kimberly Jackson is 1083380125. It was assigned to this individual provider in the NPPES registry on August 18, 2021. The provider is also known as Kimberly Millender.
Where is Kimberly Jackson located?
Kimberly Jackson practices at 1402 Penn Ave, Pittsburgh, PA 15221. The listed phone number is (412) 224-9534.
What is Kimberly Jackson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Kimberly Jackson enrolled in Medicare?
Yes. Kimberly Jackson is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kimberly Jackson was last updated on August 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kimberly Jackson · NPI 1083380125
Primary Care physician in Pittsburgh, Pennsylvania. Individual provider, active in the CMS NPPES registry since August 18, 2021.
## Identity
- **NPI:** 1083380125 (Entity type: Individual)
- **Enumerated:** August 18, 2021
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** SP024265 (Pennsylvania)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1402 PENN AVE, Pittsburgh, PA 15221-2413
- **Phone:** (412) 224-9534
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** August 18, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1083380125) · Data from the CMS NPPES public registry.