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NPI · 1104072297 · NPPES-sourced

Derrell Jackson PA-C

ActivePhysician Assistant
NPI Number
1104072297
Type 1 · Individual
Taxonomy Code
363A00000X
Contact
(804) 526-2121
License VA · 0110002804
Last Updated
About 16 years ago (May 2010)
Enumerated 2008-08-08
Primary practice addressVA · 23834-1765
436 Claremont Ct, Suite 100Colonial Heights, VA 23834-1765
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About this NPIWhat this record shows.

NPI 1104072297 is registered to Derrell Jackson PA-C, a Physician Assistant practising at 436 Claremont Ct, Suite 100 in Colonial Heights, Virginia. Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy. Derrell Jackson PA-C has been enumerated in the National Provider Identifier (NPI) registry since 2008.

Provider type
Individual (Type 1)
Status
Active
Enumerated
2008-08-08
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Secondary identifiers

Additional identifiers this provider has registered with NPPES. Used by medical billers, credentialers, and insurance verifiers to cross-reference claims and enrollments.

Medicaid

Other

  • 10040880PVA· Issued by OPTIMA
  • P00685057VA· Issued by RR MEDICARE
  • 10040880PVA· Issued by SENTARA HEALTHCARE

Source: NPPES public registry.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Derrell Jackson PA-C accepts. To confirm in-network status with your specific health plan, contact Derrell Jackson PA-C directly at (804) 526-2121.

Frequently asked

Yes. NPI 1104072297 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (804) 526-2121.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Derrell Jackson PA-C is a Type-1 individual NPI.

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Quick facts

Provider typeIndividual
Taxonomy363A00000X
Last updated2010-05
Enumerated2008-08-08
StatusActive
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1 record · same addressOther providers at this location.

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Same specialtyOther Physician Assistant providers in Virginia.

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Adjacent in the NPPES enumeration sequenceNPIs enumerated around this one.

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