KAYLYN A JACKSON PA
NPI 1104283365
Physician Assistant in Roanoke, VA

Q: What is Kaylyn Jackson's NPI number?

The NPI number for Kaylyn Jackson is 1104283365. It was assigned to this individual provider in the NPPES registry on January 19, 2016. The provider is also known as Kaylyn Price PA.

Q: What is Kaylyn Jackson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kaylyn Jackson was last updated on August 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.

Active since January 19, 2016PECOS EnrolledAccepts Medicare Assignment

2001 CRYSTAL SPRING AVE SW STE 201, ROANOKE, VA 24014(540) 853-0100 Get Directions Write a Review

NPPES record last updated: August 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 15, 2025, Jul 11, 2023, Jan 26, 2017 and 4 more (7 updates tracked since 2016).

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About Kaylyn A Jackson Pa NPPES

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

KAYLYN A JACKSON PA (NPI 1104283365) is an individual physician assistant in Roanoke, Virginia, licensed in Virginia (0110005201) and active in the NPI registry since January 2016. She is enrolled in Medicare PECOS, is affiliated with Carilion Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1104283365

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKAYLYN A JACKSONCredential: PA

Location Address2001 CRYSTAL SPRING AVE SW STE 201Roanoke, VA 24014-2465

Mailing Address213 S Jefferson St Ste 1006Roanoke, VA 24011-1713

Phone(540) 853-0100

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateJanuary 19, 2016

Last NPPES UpdateAugust 15, 20257 updates tracked since enumeration

NPPES CertifiedAugust 15, 2025

✔ NPI 1104283365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in VA · 0110005201✔ Licensed in MI · 5601011711

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 0110-005201 (VA)

2001 CRYSTAL SPRING AVE SW STE 201, Roanoke, VA 24014

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Other Names 1

Former Name (1)Kaylyn Price Pa

Secondary Practice Locations 2

Location 11100 E Michigan AveJackson, MI 49201-1847 · Phone (517) 205-4800

Location 21221 Lee St, 2nd FloorCharlottesville, VA 22908-0001 · Phone (434) 924-5052 · Fax (434) 844-7588

Other Identifiers 1

Medicaid1104283365VA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kaylyn A Jackson Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739488818

PECOS Enrollment IDI20160422002048

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Carilion Medical Center

Acute Care Hospitals · Roanoke, VA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490024

Location1906 Belleview Avenue, SERoanoke, VA 24014 · Roanoke City County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24014 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$70.08 typical visit price

range $18.07 – $138.91

Typical copayment $17.52 (range $4.51 – $34.72)

Most-billed visit code 99213

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

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.

SARAH ALYSE GUZINSKI-HOMCHA

Physician Assistant (Surgical)