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DR. KATHLEEN MARIE JACKSON MD
NPI 1801323993
Pediatrics - Pediatric Emergency Medicine in Greenville, SC

Active since May 19, 2017PECOS Enrolled
701 GROVE RD FL 1, GREENVILLE, SC 29605(864) 455-7899(864) 455-5474 Get Directions Write a Review

NPPES record last updated: July 12, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 12, 2023, Jun 19, 2023, Mar 16, 2021 and 1 more (4 updates tracked since 2017).

About Dr. Kathleen Marie Jackson Md NPPES

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

DR. KATHLEEN MARIE JACKSON MD (NPI 1801323993) is an individual pediatric emergency medicine provider in Greenville, South Carolina, licensed in South Carolina (84014) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801323993
Entity TypeIndividualFemale
Primary Taxonomy2080P0204X
Provider Legal NameDR. KATHLEEN MARIE JACKSONCredential: MD
Location Address701 GROVE RD FL 1Greenville, SC 29605-4210
Mailing Address300 E Mcbee Ave Fl 4Greenville, SC 29601-2842 · (864) 522-8603
Phone(864) 455-7899
Fax(864) 455-5474
Sole ProprietorNo
Enumeration DateMay 19, 2017
Last NPPES UpdateJuly 12, 20234 updates tracked since enumeration
NPPES CertifiedJuly 12, 2023
✔ NPI 1801323993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in SC · 84014
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
Also ListedPediatricsTaxonomy 208000000X · License 84014 (SC)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
701 GROVE RD FL 1, Greenville, SC 29605
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include First Choice Next.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kathleen Marie Jackson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Kathleen Jackson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Prisma Health University Medical Group
0.1 mi
Nurse Practitioner
712 GROVE RD
Greenville, SC 29605
  • Reassigned Medicare billing, South Carolina enrollment
  • 3,281 clinicians in this Medicare group
NPI 1053786483 (864) 455-9349
University Medical Associates
194 mi
Multi-Specialty
2125 CHARLIE HALL BLVD, SUITE 100
Charleston, SC 29414
  • Reassigned Medicare billing, South Carolina enrollment
  • Medicare enrollment name: University Medical Associates Of The Medical University Of South Carol
  • 2,594 clinicians in this Medicare group
NPI 1760413835 (843) 792-1414

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DR. AMBER GIST LANEY MD
Emergency Medicine
701 GROVE RD FL 1
GREENVILLE, SC 29605
Greenville County (864) 455-7899
JASON COLLINS NP
Nurse Practitioner (Gerontology)
701 GROVE RD FL 1
GREENVILLE, SC 29605
Greenville County (864) 455-7000
JASMINE LYNN JOLLY MD
Emergency Medicine
701 GROVE RD FL 1
GREENVILLE, SC 29605
Greenville County (864) 455-7899
DR. BRENT ALEXANDER OLDHAM MD, MPH
Emergency Medicine
701 GROVE RD FL 1
GREENVILLE, SC 29605
Greenville County (864) 455-7899
JILLIAN ROSE KENT PA-C
Physician Assistant
701 GROVE RD FL 1
GREENVILLE, SC 29605
Greenville County (864) 455-7899
CALEB SCOTT MANASCO MD
Emergency Medicine
701 GROVE RD FL 1
GREENVILLE, SC 29605
Greenville County (864) 455-7899
DEVON TRAPNELL SOWA PA-C
Physician Assistant
701 GROVE RD FL 1
GREENVILLE, SC 29605
Greenville County (864) 455-7899
MATTHEW LEWIS MULLINS
Emergency Medicine
701 GROVE RD FL 1
GREENVILLE, SC 29605
Greenville County (864) 455-7899

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 Kathleen Jackson's NPI number?

The NPI number for Kathleen Jackson is 1801323993. It was assigned to this individual provider in the NPPES registry on May 19, 2017.

Where is Kathleen Jackson located?

Kathleen Jackson practices at 701 Grove Rd Fl 1, Greenville, SC 29605. The listed phone number is (864) 455-7899.

What is Kathleen Jackson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Kathleen Jackson enrolled in Medicare?

Yes. Kathleen Jackson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kathleen Jackson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Jackson reassigns Medicare benefits to 2 organizations: Prisma Health University Medical Group (Greenville, SC) and University Medical Associates (Charleston, SC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kathleen Jackson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kathleen Jackson accept?

Health plans from First Choice Next list Kathleen 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.

When was this NPI record last updated?

The NPPES record for Kathleen Jackson was last updated on July 12, 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.