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KENZIE JACKLEY PHYSICIAN ASSISTANT
NPI 1396142568
Physician Assistant in Edina, MN

Active since December 03, 2014PECOS Enrolled
6700 FRANCE AVE S, SUITE 300, EDINA, MN 55435(952) 345-3000(952) 345-6789 Get Directions Write a Review

NPPES record last updated: November 3, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 3, 2020, Jul 14, 2016 (2 updates tracked since 2016).

About Kenzie Jackley Physician Assistant NPPES

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

KENZIE JACKLEY PHYSICIAN ASSISTANT (NPI 1396142568) is an individual physician assistant in Edina, Minnesota, licensed in Minnesota (11821) and active in the NPI registry since December 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396142568
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKENZIE JACKLEYCredential: PHYSICIAN ASSISTANT
Location Address6700 FRANCE AVE S, SUITE 300Edina, MN 55435-1902
Mailing Address6700 France Ave S Ste 300Edina, MN 55435-1908 · (952) 345-3000 · Fax (952) 345-6789
Phone(952) 345-3000
Fax(952) 345-6789
Sole ProprietorNo
Enumeration DateDecember 3, 2014
Last NPPES UpdateNovember 3, 20202 updates tracked since enumeration
NPPES CertifiedNovember 3, 2020
✔ NPI 1396142568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MN · 11821
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.
6700 FRANCE AVE S, Edina, MN 55435
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Other Names 1

Former Name (1)Kenzie Meyer

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenzie Jackley Physician Assistant 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55435 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WORLD TRAVEL HEALTH
Clinic/Center
6700 FRANCE AVE S, #150
EDINA, MN 55435
Hennepin County (952) 922-9089
ANGELA JANE EVERSON DPT
Physical Therapist
6700 FRANCE AVE S, SUITE 300
EDINA, MN 55435
Hennepin County (952) 345-3000
MELISSA MARIE WICK
Physical Therapist
6700 FRANCE AVE S, SUITE #300
EDINA, MN 55435
Hennepin County (952) 345-3000
COMMUNITY HEALTH AND IMMUNIZATION SERVICES, LLC
Community Health Worker
6700 FRANCE AVE S, SUITE 150B
EDINA, MN 55435
Hennepin County (877) 358-8648
MARISA BUSHMAN AU.D.
Audiologist
6700 FRANCE AVE S, SUITE 300
EDINA, MN 55435
Hennepin County (952) 345-3000
LISA MARIE SCHLIEFF PT
Physical Therapist
6700 FRANCE AVE S, SUITE 300
EDINA, MN 55435
Hennepin County (952) 345-3000
AMBER E DIONNE PA-C
Physician Assistant
6700 FRANCE AVE S, SUITE 300
EDINA, MN 55435
Hennepin County (952) 345-3000
KATIE JO SMITH DPT
Physical Therapist
6700 FRANCE AVE S, SUITE 300
EDINA, MN 55435
Hennepin County (952) 345-3000

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 Kenzie Jackley's NPI number?

The NPI number for Kenzie Jackley is 1396142568. It was assigned to this individual provider in the NPPES registry on December 3, 2014. The provider is also known as Kenzie Meyer.

Where is Kenzie Jackley located?

Kenzie Jackley practices at 6700 France Ave S Suite 300, Edina, MN 55435. The listed phone number is (952) 345-3000.

What is Kenzie Jackley's specialty?

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

Is Kenzie Jackley enrolled in Medicare?

Yes. Kenzie Jackley is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenzie Jackley was last updated on November 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.