Kelly Jackson
NPI 1831582204ActiveOrganization· Physician Assistant, Surgical· Scottsdale, AZ
Physician Assistant, Surgical in Scottsdale, Arizona, registered in NPPES in March 2015. The authorized official on file is Kelly Jackson, NP, Owner.
Overview
| NPI | 1831582204 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 10, 2015 |
| Last updated in NPPES | Mar 10, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Surgical Primary | 363AS0400X | AP4200 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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