Mishi Kavon Jackson, MD in Kernersville, NC

Mishi Kavon Jackson, MD is a medicare enrolled "Family Medicine" physician in Kernersville, North Carolina. She went to University Of Mississippi School Of Medicine and graduated in 1993 and has 31 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Novant Medical Group Inc and her current practice location is 1471 Jag Branch Blvd Unit 103, Kernersville, North Carolina. You can reach out to her office (for appointments etc.) via phone at (336) 515-7410.

Mishi Kavon Jackson is licensed to practice in North Carolina (license number 200600012) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1215006192.

Contact Information

	Mishi Kavon Jackson, MD
	1471 Jag Branch Blvd Unit 103, Kernersville, NC 27284-6963
	(336) 515-7410
	(336) 515-7419

Map and Direction

Physician's Profile

Full Name	Mishi Kavon Jackson
Gender	Female
Speciality	Family Practice
Experience	31 Years
Location	1471 Jag Branch Blvd Unit 103, Kernersville, North Carolina
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mishi Kavon Jackson attended and graduated from University Of Mississippi School Of Medicine in 1993

NPI Data:

NPI Number: 1215006192
Provider Enumeration Date: 11/07/2006
Last Update Date: 03/07/2023

Medicare PECOS Information:

PECOS PAC ID: 6002824398
Enrollment ID: I20060328000656

Medical Identifiers

Medical identifiers for Mishi Kavon Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215006192	NPI	-	NPPES
42515	Other	NC	PARTNERS MEDICARE
5904650	Medicaid	NC
187165	Other	NC	MEDCOST
141YE	Other	NC	BCBS OF NC
P00650299	Other	NC	RR MEDICARE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	200600012 (North Carolina)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Novant Health Forsyth Medical Center	Winston-salem, NC	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Novant Medical Group Inc	1153234893	1996

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mishi Kavon Jackson allows following entities to bill medicare on her behalf.

Entity Name	Wake Forest Health Network Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477785756 PECOS PAC ID: 4183538895 Enrollment ID: O20031117000868

Entity Name	Novant Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366409492 PECOS PAC ID: 1153234893 Enrollment ID: O20031121000692

Entity Name	Alamance Regional Medical Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326010273 PECOS PAC ID: 5294647145 Enrollment ID: O20040504000878

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. Mishi Kavon 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 Address	Practice Location Address
Mishi Kavon Jackson, MD Po Box 60447, Charlotte, NC 28260-0447 Ph: () -	Mishi Kavon Jackson, MD 1471 Jag Branch Blvd Unit 103, Kernersville, NC 27284-6963 Ph: (336) 515-7410

Reviews and Comments

Family Medicine Doctors in Kernersville, NC

Richard Ray Herber, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 900 Old Winston Rd, Kernersville, NC 27284 Phone: 336-713-8077
Dr. Frances E. Dechurch, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1750 Kernersville Medical Pkwy, Kernersville, NC 27284 Phone: 336-564-4866 Fax: 336-564-4869
Barry Dean Stringfield, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 861 Old Winston Rd Ste 101, Kernersville, NC 27284 Phone: 336-713-0990 Fax: 336-713-0980
Dr. Alison Townsend Snider, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 900 Old Winston Rd, Suite 222, Kernersville, NC 27284 Phone: 336-992-1234 Fax: 336-993-9963
Dr. Angela Oh Park Antipin, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 794 S Main St Ste B, Kernersville, NC 27284 Phone: 336-904-2317 Fax: 336-443-6030
David B Massey, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 111 Gateway Center Dr, Kernersville, NC 27284 Phone: 336-996-2173 Fax: 336-996-3254

Mishi Kavon Jackson, MD - Medicare Family Practice in Kernersville, NC