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RANDY D JACKSON PA-C
NPI 1508825357
Physician Assistant in Millinocket, ME

Active since March 21, 2006
200 SOMERSET ST, SUITE 2, MILLINOCKET, ME 04462(207) 723-5173(207) 723-3040 Get Directions Write a Review

NPPES record last updated: February 11, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Randy D Jackson Pa-c NPPES

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

RANDY D JACKSON PA-C (NPI 1508825357) is an individual physician assistant in Millinocket, Maine, licensed in Maine (PA-028) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1508825357
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameRANDY D JACKSONCredential: PA-C
Location Address200 SOMERSET ST, SUITE 2Millinocket, ME 04462-1258
Mailing Address200 Somerset StMillinocket, ME 04462-1258 · (207) 723-5173 · Fax (207) 723-3040
Phone(207) 723-5173
Fax(207) 723-3040
Sole ProprietorNo
Enumeration DateMarch 21, 2006
Last NPPES UpdateFebruary 11, 2013
✔ NPI 1508825357 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 ME · PA-028
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.
200 SOMERSET ST, Millinocket, ME 04462
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Other Identifiers 4

Other079032ME · Anthem
Medicaid1508825357ME
Other201855ME · Ngs
Medicare ID-Type UnspecifiedAP0404ME · Nhic

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.

EDWARD J DUNSTAN DO
Family Medicine
200 SOMERSET ST, SUITE 3
MILLINOCKET, ME 04462
Penobscot County (207) 723-5173
DANIEL C HERBERT M.D.
Internal Medicine
200 SOMERSET ST
MILLINOCKET, ME 04462
Penobscot County (207) 723-5161
JOSEPH AQUILINA FNPC
Nurse Practitioner (Family)
200 SOMERSET ST, SUITE 2
MILLINOCKET, ME 04462
Penobscot County (207) 794-6700
KWAKU OWUSU-ABROKWA M.D.
Internal Medicine
200 SOMERSET ST
MILLINOCKET, ME 04462
Penobscot County (207) 723-5173
MS. JULIA ANN WILLIAMS RD
Dietitian, Registered
200 SOMERSET ST
MILLINOCKET, ME 04462
Penobscot County (207) 723-5161
MILLINOCKET REGIONAL HOSPITAL
General Acute Care Hospital (Critical Access)
200 SOMERSET ST
MILLINOCKET, ME 04462
Penobscot County (207) 723-5161
MILLINOCKET REGIONAL HOSPITAL
General Acute Care Hospital (Critical Access)
200 SOMERSET ST
MILLINOCKET, ME 04462
Penobscot County (207) 723-5161
KENNETH R RITCHIE
Physical Therapy Assistant
200 SOMERSET ST
MILLINOCKET, ME 04462
Penobscot County (207) 543-6252

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 Randy Jackson's NPI number?

The NPI number for Randy Jackson is 1508825357. It was assigned to this individual provider in the NPPES registry on March 21, 2006.

Where is Randy Jackson located?

Randy Jackson practices at 200 Somerset St Suite 2, Millinocket, ME 04462. The listed phone number is (207) 723-5173.

What is Randy Jackson's specialty?

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

When was this NPI record last updated?

The NPPES record for Randy Jackson was last updated on February 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.