KELLY NICOLE JACKSON FNP
NPI 1306505854
Nurse Practitioner - Family in Kingsport, TN

NPI Status: Active since December 13, 2021

Contact Information

4 SHERIDAN SQ STE 102
KINGSPORT, TN
ZIP 37660
Phone: (423) 588-7140
Fax: (423) 588-7141

Recently Updated NPI Information
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.

Table of Contents

NPI Profile Information
Primary Taxonomy
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Nurse Practitioner
Family

About KELLY JACKSON

This page provides the complete NPI Profile along with additional information for Kelly Jackson, a provider established in Kingsport, Tennessee with a medical specialization in Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1306505854 assigned on December 2021. The practitioner's primary taxonomy code is 363LF0000X with license number 30680 (TN). The provider is registered as an individual and her NPI record was last updated May 2026.

NPI: 1306505854
Provider Name: KELLY NICOLE JACKSON FNP
Gender: Female
Entity Type: Individual
Location Address: 4 SHERIDAN SQ STE 102 KINGSPORT, TN 37660
Location Phone: (423) 588-7140
Location Fax: (423) 588-7141
Mailing Address: 6016 BROOKVALE LN STE 200 KNOXVILLE, TN 37919
Mailing Phone: (865) 862-0998
Mailing Fax: (423) 588-7141
Is Sole Proprietor?: No
Enumeration Date: 12-13-2021
Last Update Date: 05-21-2026
Code Navigator

A nurse practitioner (NP) like Kelly Jackson is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Nurse Practitioner Family
Taxonomy Code: 363LF0000X
Type: Physician Assistants & Advanced Practice Nursing Providers
License No.: 30680
License State: TN

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1306505854, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 0

Pos 4

Unchanged

Pos 5

Doubled → 10 → 1 + 0

Pos 6

Unchanged

Pos 7

Doubled → 10 → 1 + 0

Pos 8

Unchanged

Pos 9

Doubled → 10 → 1 + 0

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 5 → 10 → 1 5 → 10 → 1 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 0 + 6 + 1 + 0 + 0 + 1 + 0 + 8 + 1 + 0 + 24 = 46

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 46 is 50. The difference is the calculated check digit.

50 - 46 = 4

This NPI is valid

The calculated check digit is 4, which matches the last digit of 1306505854.