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JACKSON FAMILY MEDICINE AND WELLNESS CENTER INC.
NPI 1780561118
Nurse Practitioner - Family in Denver, NC

Active since August 18, 2025CLIA 34D2333292 · Waiver
4764 N NC 16 BUSINESS HWY, DENVER, NC 28037(980) 222-7004(980) 375-1173 Get Directions Write a Review

NPPES record last updated: February 15, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Jackson Family Medicine And Wellness Center Inc. NPPES

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

JACKSON FAMILY MEDICINE AND WELLNESS CENTER INC. (NPI 1780561118) is a healthcare organization registered as a family in Denver, North Carolina and active in the NPI registry since August 2025. The organization holds a CLIA Waiver certificate valid through November 2, 2027 and lists Kimberly Jackson, President, as its authorized official.

NPPES Registry Identity

NPI1780561118
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameJACKSON FAMILY MEDICINE AND WELLNESS CENTER INC.
Location Address4764 N NC 16 BUSINESS HWYDenver, NC 28037-7915
Mailing Address4764 N Nc 16 Business HwyDenver, NC 28037-7915 · (980) 222-7004 · Fax (980) 375-1173
Phone(980) 222-7004
Fax(980) 375-1173
Organization SubpartNo
Authorized OfficialKimberly JacksonPresident · (704) 320-5347
Enumeration DateAugust 18, 2025
Last NPPES UpdateFebruary 15, 2026
NPPES CertifiedFebruary 15, 2026
✔ NPI 1780561118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
4764 N NC 16 BUSINESS HWY, Denver, NC 28037
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2333292

Jackson Family Medicine And Wellness Center · Denver, NC
Active · expires Nov 2, 2027
CLIA Number34D2333292
Laboratory TypePhysician Office
Certificate Effective DateNovember 3, 2025
Certificate Expiration DateNovember 2, 2027
Laboratory DirectorKimberly Jackson
Laboratory Phone(980) 222-7004
Laboratory LocationJackson Family Medicine And Wellness Center4764 N Nc 16 Business Hwy, Denver, NC 28037
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

KIMBERLY JACKSON DNP, FNP-BC
Nurse Practitioner (Family)
4764 N NC 16 BUSINESS HWY
DENVER, NC 28037
Lincoln County (980) 222-7004

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 Family Medicine And Wellness Center Inc.'s NPI number?

The NPI number for Jackson Family Medicine And Wellness Center Inc. is 1780561118. It was assigned to this organization in the NPPES registry on August 18, 2025.

Where is Jackson Family Medicine And Wellness Center Inc. located?

Jackson Family Medicine And Wellness Center Inc. is located at 4764 N Nc 16 Business Hwy, Denver, NC 28037. The listed phone number is (980) 222-7004.

What is Jackson Family Medicine And Wellness Center Inc.'s specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Jackson Family Medicine And Wellness Center Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2333292) is associated with this NPI, valid through November 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jackson Family Medicine And Wellness Center Inc. was last updated on February 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.