KELCY LEIGH JACKSON MD
NPI 1316797269
Student in an Organized Health Care Education/Training Program in Charlotte, NC

Q: What is Kelcy Jackson's NPI number?

The NPI number for Kelcy Jackson is 1316797269. It was assigned to this individual provider in the NPPES registry on March 25, 2024.

Q: What is Kelcy Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Kelcy Jackson was last updated on June 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 March 25, 2024PECOS Enrolled

1350 S KINGS DR, CHARLOTTE, NC 28207(704) 446-1554 Get Directions Write a Review

NPPES record last updated: June 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kelcy Leigh Jackson Md NPPES

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

KELCY LEIGH JACKSON MD (NPI 1316797269) is an individual student in an organized health care education/training program in Charlotte, North Carolina and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316797269

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameKELCY LEIGH JACKSONCredential: MD

Location Address1350 S KINGS DRCharlotte, NC 28207-2134

Mailing Address1350 S Kings DrCharlotte, NC 28207-2134 · (704) 446-1544 · Fax (704) 446-1551

Phone(704) 446-1554

Sole ProprietorNo

Enumeration DateMarch 25, 2024

Last NPPES UpdateJune 8, 2024

NPPES CertifiedJune 8, 2024

✔ NPI 1316797269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1350 S KINGS DR, Charlotte, NC 28207

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelcy Leigh Jackson Md 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.

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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.

KRISTINA JASMIN HARRELL MD

Pediatrics (Pediatric Hematology-Oncology)