DR. KATHY JO JACKSON M.D.
NPI 1306914296
Pediatrics in Kalamazoo, MI

Q: What is Kathy Jackson's NPI number?

The NPI number for Kathy Jackson is 1306914296. It was assigned to this individual provider in the NPPES registry on December 1, 2006.

Q: What is Kathy Jackson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Kathy Jackson was last updated on December 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since December 01, 2006PECOS Enrolled

117 W PATERSON ST, KALAMAZOO, MI 49007(269) 349-2641(269) 349-2898 Get Directions Write a Review

NPPES record last updated: December 27, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Kathy Jo Jackson M.d. NPPES

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

DR. KATHY JO JACKSON M.D. (NPI 1306914296) is an individual pediatrics provider in Kalamazoo, Michigan, licensed in Michigan (070748) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Kalamazoo.

NPPES Registry Identity

NPI1306914296

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. KATHY JO JACKSONCredential: M.D.

Location Address117 W PATERSON STKalamazoo, MI 49007-2557

Mailing Address1003 Pinehurst BlvdKalamazoo, MI 49006-2110 · (269) 349-2641 · Fax (269) 349-2898

Phone(269) 349-2641

Fax(269) 349-2898

Sole ProprietorNo

Enumeration DateDecember 1, 2006

Last NPPES UpdateDecember 27, 2022

NPPES CertifiedDecember 27, 2022

✔ NPI 1306914296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MI · 070748

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

117 W PATERSON ST, Kalamazoo, MI 49007

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Secondary Practice Location 1

Location 1505 E Alcott StKalamazoo, MI 49001-6144 · Phone (269) 349-2641

Other Identifiers 1

Medicaid104509048MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kathy Jo 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.

Medicare Billing Reassignment

Medicare enrollment records show Kathy Jackson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Family Health Center Inc

Same address

Federally Qualified Health Center (FQHC)

117 W PATERSON STREET
Kalamazoo, MI 49007

Reassigned Medicare billing, Michigan enrollment
75 clinicians in this Medicare group

NPI 1811065576 (269) 349-2641

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49007 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

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.

SUSAN MARIE PEREZ NP

Nurse Practitioner (Pediatrics)