DR. KIM JACKSON PHD
NPI 1285177261
Counselor - Mental Health in Anchorage, AK
About Dr. Kim Jackson Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KIM JACKSON PHD (NPI 1285177261) is an individual mental health provider in Anchorage, Alaska and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 4
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Kim Jackson Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kim Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Westminster, CO 80003
- Reassigned Medicare billing, Colorado enrollment
- 6 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Kim Jackson's NPI number?
The NPI number for Kim Jackson is 1285177261. It was assigned to this individual provider in the NPPES registry on November 23, 2016.
Where is Kim Jackson located?
Kim Jackson practices at 3330 Artic Blvd Ste 101, Anchorage, AK 99503. The listed phone number is (907) 600-3425.
What is Kim Jackson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Kim Jackson enrolled in Medicare?
Yes. Kim Jackson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kim Jackson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kim Jackson reassigns Medicare benefits to Michelle R Simmons, Lpc, LLC (Westminster, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kim Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kim Jackson was last updated on September 26, 2022. 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.
# Dr. Kim Jackson, PHD · NPI 1285177261
Mental Health provider in Anchorage, Alaska. Individual provider, active in the CMS NPPES registry since November 23, 2016.
## Identity
- **NPI:** 1285177261 (Entity type: Individual)
- **Enumerated:** November 23, 2016
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** No
## Practice location
- **Address:** 3330 ARTIC BLVD STE 101, Anchorage, AK 99503-4580
- **Phone:** (907) 600-3425
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Michelle R Simmons, Lpc, LLC (NPI 1093268377, Westminster, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 26, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1285177261) · Data from the CMS NPPES public registry.