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HOLLY JACKSON PA-C
NPI 1467826248
Physician Assistant in College Station, TX

Active since November 17, 2015PECOS EnrolledAccepts Medicare Assignment
4421 HIGHWAY 6 S STE 100, COLLEGE STATION, TX 77845(979) 731-5200(979) 731-5210 Get Directions Write a Review

NPPES record last updated: January 23, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 23, 2023, Nov 28, 2018, Dec 28, 2015 and 1 more (4 updates tracked since 2015).

About Holly Jackson Pa-c NPPES

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

HOLLY JACKSON PA-C (NPI 1467826248) is an individual physician assistant in College Station, Texas, licensed in Texas (PA10119) and active in the NPI registry since November 2015. She is enrolled in Medicare PECOS, is affiliated with Baylor Scott And White Medical Center Lake Pointe, and maintains a secondary practice location in Granbury.

NPPES Registry Identity

NPI1467826248
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameHOLLY JACKSONCredential: PA-C
Location Address4421 HIGHWAY 6 S STE 100College Station, TX 77845-6176
Mailing Address805 Hill Blvd Unit 104Granbury, TX 76048-1482 · (817) 573-5760
Phone(979) 731-5200
Fax(979) 731-5210
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateNovember 17, 2015
Last NPPES UpdateJanuary 23, 20234 updates tracked since enumeration
NPPES CertifiedJanuary 23, 2023
✔ NPI 1467826248 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 TX · PA10119
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.
4421 HIGHWAY 6 S STE 100, College Station, TX 77845
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Other Names 1

Former Name (1)Holly Koonce Pa-c

Secondary Practice Location 1

Location 1805 Hill Blvd Unit 104Granbury, TX 76048-1482 · Phone (817) 573-5760

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Holly Jackson Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658644216
PECOS Enrollment IDI20170901000223
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baylor Scott And White Medical Center Lake Pointe

Acute Care Hospitals · Rowlett, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450742
Location6800 Scenic DrRowlett, TX 75088 · Dallas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77845 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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 4

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

JANET KRUEGER M.D.
Emergency Medicine (Emergency Medical Services)
4421 HIGHWAY 6 S STE 100
COLLEGE STATION, TX 77845
Brazos County (979) 731-5200
KELLI RICH NP-C
Nurse Practitioner (Family)
4421 HIGHWAY 6 S STE 100
COLLEGE STATION, TX 77845
Brazos County (979) 731-5200
JANA KIMBERLIN FNP
Nurse Practitioner (Family)
4421 HIGHWAY 6 S STE 100
COLLEGE STATION, TX 77845
Brazos County (979) 731-5200
DR. MARIO RIZALINO BASCON ROA JR. M.D.
Family Medicine
4421 HIGHWAY 6 S STE 100
COLLEGE STATION, TX 77845
Brazos County (979) 731-5200

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 Holly Jackson's NPI number?

The NPI number for Holly Jackson is 1467826248. It was assigned to this individual provider in the NPPES registry on November 17, 2015. The provider is also known as Holly Koonce Pa-C.

Where is Holly Jackson located?

Holly Jackson practices at 4421 Highway 6 S Ste 100, College Station, TX 77845. The listed phone number is (979) 731-5200.

What is Holly Jackson's specialty?

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

Is Holly Jackson enrolled in Medicare?

Yes. Holly Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Holly Jackson accept?

Health plans from Blue Cross and Blue Shield of Texas list Holly Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Holly Jackson affiliated with any hospitals?

According to CMS data, Holly Jackson is affiliated with Baylor Scott And White Medical Center Lake Pointe.

When was this NPI record last updated?

The NPPES record for Holly Jackson was last updated on January 23, 2023. 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.