DR. JACQUELINE KAY JACKSON M.D.
NPI 1104157643
Family Medicine - Adult Medicine in Gainesville, FL

Q: What is Jacqueline Jackson's NPI number?

The NPI number for Jacqueline Jackson is 1104157643. It was assigned to this individual provider in the NPPES registry on January 22, 2010.

Q: What is Jacqueline Jackson's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Active since January 22, 2010PECOS Enrolled

1621 NE WALDO RD, GAINESVILLE, FL 32609(352) 264-8272(352) 264-8304 Get Directions Write a Review

NPPES record last updated: February 25, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Jacqueline Kay Jackson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACQUELINE KAY JACKSON M.D. (NPI 1104157643) is an individual adult medicine provider in Gainesville, Florida, licensed in Florida (ME 0058078) and active in the NPI registry since January 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104157643

Entity TypeIndividualFemale

Primary Taxonomy207QA0505X

Provider Legal NameDR. JACQUELINE KAY JACKSONCredential: M.D.

Location Address1621 NE WALDO RDGainesville, FL 32609-3900

Mailing Address1200 Ne 55th BlvdGainesville, FL 32641-2759 · (352) 264-8272 · Fax (352) 264-8304

Phone(352) 264-8272

Fax(352) 264-8304

Sole ProprietorNo

Enumeration DateJanuary 22, 2010

Last NPPES UpdateFebruary 25, 2019

✔ NPI 1104157643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QA0505X

License✔ Licensed in FL · ME 0058078

Definition

The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

1621 NE WALDO RD, Gainesville, FL 32609

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Other Identifiers 1

Medicaid010829000FL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacqueline Kay Jackson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32609 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409

DME-Orthotic Devices · category DF010N

1 supplier12 claims240 services$5.65 avg. paid by Medicare

Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each A4413

DME-Orthotic Devices · category DF010N

1 supplier11 claims220 services$4.84 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. XAI MA M.D.

Family Medicine