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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACKSON ROTTIER
NPI 1679400279
Physician Assistant in Edgewood, KY

Active since May 06, 2026
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017(859) 301-9010(859) 301-9018 Get Directions Write a Review

NPPES record last updated: October 6, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 6, 2026, May 6, 2026 (2 updates tracked since 2026).

About Jackson Rottier NPPES

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

JACKSON ROTTIER (NPI 1679400279) is an individual physician assistant in Edgewood, Kentucky, licensed in Kentucky (TC112) and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1679400279
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJACKSON ROTTIER
Location Address1 MEDICAL VILLAGE DREdgewood, KY 41017-3403
Mailing AddressPo Box 636324Cincinnati, OH 45263-6324 · (859) 301-9010 · Fax (859) 301-9018
Phone(859) 301-9010
Fax(859) 301-9018
Sole ProprietorYes
Enumeration DateMay 6, 2026
Last NPPES UpdateOctober 6, 20262 updates tracked since enumeration
NPPES CertifiedMay 6, 2026
✔ NPI 1679400279 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 KY · TC112
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.
1 MEDICAL VILLAGE DR, Edgewood, KY 41017
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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.

CARA LINDSAY HANSEN CRNA
Nurse Anesthetist, Certified Registered
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 301-2000
MRS. COURTNEY E COFFEY PA-C
Physician Assistant
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 301-9010
DR. KELLY ANN MACKESSY DO
Surgery (Surgical Oncology)
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 578-5880
LYNDSEY LANG MS, RN, NNP-BC
Nurse Practitioner
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 301-2423
MS. STEPHANIE ANNE STEGMAN CRNA
Nurse Anesthetist, Certified Registered
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 301-2000
MICHELLE F PANDIT MD
Emergency Medicine
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 301-2250
ELLE KAISER DNP,CRNA
Nurse Anesthetist, Certified Registered
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 301-2000
MRS. ANITA KAY PHILLIPS ARNP-C
Nurse Practitioner
1 MEDICAL VILLAGE DR
EDGEWOOD, KY 41017
Kenton County (859) 301-8074

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 Rottier's NPI number?

The NPI number for Jackson Rottier is 1679400279. It was assigned to this individual provider in the NPPES registry on May 6, 2026.

Where is Jackson Rottier located?

Jackson Rottier practices at 1 Medical Village Dr, Edgewood, KY 41017. The listed phone number is (859) 301-9010.

What is Jackson Rottier'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 Jackson Rottier was last updated on October 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days 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.