NPI age
17 years
Enumerated 2009-03-11
● Active
Type 1 · Individual
Kierney Elizabeth Jackson, PA
Jackson is 1 of 108 physician assistant providers in Gainesville and 1 of 4616 in Georgia.
Primary specialty
Physician Assistant
Plus 2 subspecialties
Licensed in
GA, SC, NC
3 states
Status
Active
No deactivations on record
Last NPPES update
2025-09-25
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 4616 active physician assistant providers in Georgia.
NPI age
17 years
↑ 9 yr above median (8 yr)
State licenses
3 states
Top 90% — 9% of peers are multi-state
Subspecialties
0
24% of peers hold subspecialties
NPI lifetime · 2009 → 2026
2009-03Enumerated in NPPES
2009
2026
Where they practice
Practice location
200 S Enota Dr Ne Ste 360
Gainesville, GA 305013466
Mailing address
Po Box 742616
Atlanta, GA 303742616
Additional practice locations
1 secondary location on file with NPPES.
Location 2
1350 S Kings Dr
Charlotte, NC 282072134
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | 0949PA | |
| 05 (NC) | 1003057621 |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
Recently enumerated nearby: 9 new physician assistant providers have been added in Gainesville in the last 180 days.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.