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JACKSON ELLIS KIMBROUGH PA
NPI 1639064900
Physician Assistant in Birmingham, AL

Active since June 09, 2025PECOS EnrolledAccepts Medicare Assignment
619 19TH ST S, BIRMINGHAM, AL 35233(205) 934-4011 Get Directions Write a Review

NPPES record last updated: April 17, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 17, 2026, Jun 9, 2025 (2 updates tracked since 2025).

About Jackson Ellis Kimbrough Pa NPPES

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

JACKSON ELLIS KIMBROUGH PA (NPI 1639064900) is an individual physician assistant in Birmingham, Alabama, licensed in Alabama (PA.2760) and active in the NPI registry since June 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1639064900
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJACKSON ELLIS KIMBROUGHCredential: PA
Location Address619 19TH ST SBirmingham, AL 35233-1900
Mailing AddressPo Box 55310Birmingham, AL 35255-5310
Phone(205) 934-4011
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateJune 9, 2025
Last NPPES UpdateApril 17, 20262 updates tracked since enumeration
NPPES CertifiedApril 17, 2026
✔ NPI 1639064900 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 AL · PA.2760
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.
619 19TH ST S, Birmingham, AL 35233
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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 and accepts Medicare assignment

Jackson Ellis Kimbrough Pa 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 ID4082180187
PECOS Enrollment IDI20260416001369
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 35233 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
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 20

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

SASHA KAISER MD
Emergency Medicine (Medical Toxicology)
619 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-4011
SHANNON MARIE HARRISON BSN, RN
Registered Nurse
619 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-6050
DELAINY SANFORD
Physician Assistant
619 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 731-9701
REBEKAH CATHLEEN BOWIE MD
Emergency Medicine
619 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-4011
CARLOS ARISTIZABAL
Hospitalist
619 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-4011
ELLIOTT K GOZANSKY MD
Radiology (Diagnostic Radiology)
619 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-4011
KATIA KHOURY
Internal Medicine (Hematology)
619 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-4011
KYLE STIGALL MD
Surgery (Trauma Surgery)
619 19TH ST S
BIRMINGHAM, AL 35233
Jefferson County (205) 934-4011

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 Jackson Kimbrough's NPI number?

The NPI number for Jackson Kimbrough is 1639064900. It was assigned to this individual provider in the NPPES registry on June 9, 2025.

Where is Jackson Kimbrough located?

Jackson Kimbrough practices at 619 19th St S, Birmingham, AL 35233. The listed phone number is (205) 934-4011.

What is Jackson Kimbrough's specialty?

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

Is Jackson Kimbrough enrolled in Medicare?

Yes. Jackson Kimbrough 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.

When was this NPI record last updated?

The NPPES record for Jackson Kimbrough was last updated on April 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.