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

Q: 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.

Q: What is Kathleen Jackson's specialty?

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

Q: 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.

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: August 09, 2026.

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

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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, and ordering and referring status from the CMS PECOS system.

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.

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