KAYLYN A. JACKSON (NPI# 1104283365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104283365 |
| Entity Type | Individual |
| Full Name | KAYLYN A. JACKSON |
| Other Name | KAYLYN PRICE |
| Credential | PA |
| Practice Address |
1221 Lee St 2nd Floor Charlottesville VA 22908-0001 |
| Mailing Address |
Po Box 9007 Charlottesville VA 22906-9007 |
| Practice Telephone | 4349245052 |
| Practice Fax Number | 4348447588 |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2017-01-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
0110-005201 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1104283365 | 05 |
| Street Address |
1221 LEE ST 2ND FLOOR |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22908-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043214620 | Dean C Weil | Registered Nurse | 1221 Lee St, Charlottesville, VA 22908-0001 | 2005-06-10 |
| 1588294581 | Karen Anne Duffy | Nurse Practitioner | 1221 Lee St, Charlottesville, VA 22908-5801 | 2020-01-19 |
| 1811542624 | Jana Maire Galuppo | Physician Assistant | 1221 Lee St, Charlottesville, VA 22908-3353 | 2019-08-08 |
| 1598216426 | Keri Ann Johnson | Nurse Practitioner | 1221 Lee St, Charlottesville, VA 22908-2927 | 2016-10-15 |
| 1992168132 | April Kavanagh | Family Medicine | 1221 Lee St, Charlottesville, VA 22908 | 2016-04-04 |
| 1922472042 | Barbara L. Royston | Advanced Practice Midwife | 1221 Lee St, Charlottesville, VA 22908-0001 | 2015-12-01 |
| 1285000315 | Joyce Suh | Clinical Neuropsychologist | 1221 Lee St, Charlottesville, VA 22908-1534 | 2015-08-12 |
| 1467847541 | Richard Harold Flowers Iv | Dermatology | 1221 Lee St, Charlottesville, VA 22908-0816 | 2015-04-05 |
| 1073901336 | Tanya L. Prachar | Nurse Practitioner | 1221 Lee St, Charlottesville, VA 22908-0001 | 2015-01-08 |
| 1063811487 | Laurie Brenner | Clinical Neuropsychologist | 1221 Lee St, Charlottesville, VA 22908-0001 | 2014-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568020410 | Alexis Evans | Physician Assistant | 1215 Lee St Nnicu, Charlottesville, VA 22908 | 2019-06-04 |
| 1649702317 | Ryan Aschenbrener | Student in an Organized Health Care Education/Training Program | 545 Ray C Hunt Drive Suite 2400, Charlottesville, VA 22908 | 2017-03-31 |
| 1215399241 | Katherine Gresham Belote | Student in an Organized Health Care Education/Training Program | 1221 Lee Street Uva Health System, Charlottesville, VA 22908 | 2016-03-29 |
| 1851776215 | Catherine Meller | Student in an Organized Health Care Education/Training Program | 1215 Lee St., Box 800713, Charlottesville, VA 22908 | 2015-07-28 |
| 1295112597 | Breanna Campbell | Internal Medicine | 1220 Lee St Ste 2401, Charlottesville, VA 22908 | 2015-05-06 |
| 1013255637 | Melinda Bowles-childress | Nurse Practitioner | 1 Hospital Dr Fl 1, Charlottesville, VA 22908 | 2013-01-17 |
| 1053521757 | Univeristy of Virginia Health System | General Acute Care Hospital | University of Virginia Health System, 1215 Lee Street, Chalrlottesville, VA 22908 | 2007-05-23 |
| 1730241282 | Imre Noth | Internal Medicine | 1221 Lee St Fl 2, Charlottesville, VA 22908 | 2006-12-14 |
| 1023185394 | Tamer Ghanem | Otolaryngology | Dept. Otolaryngology, University of Virginia, 1 Hospital Dr., 2nd Floor Oms Rm 2747, Charlottesville, VA 22908 | 2006-11-29 |
| 1366401242 | Lisa M Christianson | Obstetrics & Gynecology | Uva Elson Student Health Center, 400 Brandon Avenue, Charlottesville, VA 22908 | 2006-03-21 |
| Find all providers in zip 22908 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861881682 | Nicholas F. Calabrese | Physician Assistant | 545 Ray C. Hunt Dr., Charlottesville, VA 22903-7851 | 2015-01-16 |
| 1366585952 | Alyssa Benning | Physician Assistant | 1 Hospital Dr Fl 3, Charlottesville, VA 22908-0001 | 2007-02-14 |
| 1851370589 | Gina L. Mitchell | Physician Assistant | 500 Martha Jefferson Dr Fl 5, Charlottesville, VA 22911 | 2006-01-11 |
| 1417316431 | Tara L. Deacon | Physician Assistant | 1215 Lee St, 2nd Floor, Charlottesville, VA 22908-0001 | 2016-02-18 |
| 1073916045 | Kristin L Lilly | Physician Assistant | 1215 Lee St Fl 2, Charlottesville, VA 22908-0816 | 2014-10-03 |
| 1023410248 | Bryan V. Anderson | Physician Assistant | 1215 Lee St, Charlottesville, VA 22908-0001 | 2014-09-18 |
| 1790100964 | John R. Curry | Physician Assistant | Hospital Dr, 4th Floor, Charlottesville, VA 22908-0001 | 2014-02-25 |
| 1962827139 | Danielle A. Moses | Physician Assistant | Lee St Fl 2, Charlottesville, VA 22908-0001 | 2014-02-25 |
| 1538584057 | Eileen C. Dearth | Physician Assistant | 1215 Lee St Fl 2, Charlottesville, VA 22908-0001 | 2014-02-20 |
| 1235561135 | Claire B. Denny | Physician Assistant | 545 Ray C. Hunt Drive, Charlottesville, VA 22906-0001 | 2013-08-01 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22908 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.