Kodi Long Jackson, PA - Medicare Physician Assistant in Jackson, MS

Kodi Long Jackson, PA is a medicare enrolled "Physician Assistant" in Jackson, Mississippi. Her current practice location is 971 Lakeland Dr Ste 356, Jackson, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 200-4644.

Kodi Long Jackson is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1588373716.

Contact Information

Kodi Long Jackson, PA
971 Lakeland Dr Ste 356,
Jackson, MS 39216-4607
(601) 200-4644
(601) 200-4645



Provider's Profile

Full NameKodi Long Jackson
GenderFemale
SpecialityPhysician Assistant
Location971 Lakeland Dr Ste 356, Jackson, Mississippi
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1588373716
  • Provider Enumeration Date: 11/16/2022
  • Last Update Date: 03/06/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 2769833268
  • Enrollment ID: I20240109003427

Medical Identifiers

Medical identifiers for Kodi Long Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1588373716NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant (* (Not Available))Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kodi Long Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kodi Long Jackson, PA
5959 S Sherwood Forest Blvd,
Baton Rouge, LA 70816-6038

Ph: (601) 200-4644
Kodi Long Jackson, PA
971 Lakeland Dr Ste 356,
Jackson, MS 39216-4607

Ph: (601) 200-4644

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Physician Assistant Nurses in Jackson, MS

David Andrew Porter, PA
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 2500 N State St, Jackson, MS 39216
Phone: 601-984-1000    
Rowdy Chance Lee, MD
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 2500 N State St, Jackson, MS 39216
Phone: 601-984-5153    
Kelsey A North, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 971 Lakeland Dr Ste 1460, Jackson, MS 39216
Phone: 513-708-4211    
Mary Allison Durr, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1325 E Fortification St, Jackson, MS 39202
Phone: 601-354-4488    Fax: 601-914-1835
Sarah Joanna Mason, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 7275 S Siwell Rd, Jackson, MS 39272
Phone: 601-373-7722    Fax: 601-373-7128
Mrs. Victoria Nicole Lott, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 971 Lakeland Dr Ste 656, Jackson, MS 39216
Phone: 601-366-6606    
Heather Morris, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1190 N State St Ste 502, Jackson, MS 39202
Phone: 601-944-1781    

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