Brooke E Jackson, PA, RD, LD is a medicare enrolled "Physician Assistant" provider in Charleston, South Carolina. Her current practice location is
171 Ashley Ave, Charleston, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(843) 792-3020.
Brooke E Jackson is licensed to practice in South Carolina (license number 3074) 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 1952789638.
Healthcare Provider's Profile
Full Name | Brooke E Jackson |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 171 Ashley Ave, Charleston, South Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1952789638
- Provider Enumeration Date: 05/13/2015
- Last Update Date: 10/09/2018
Medicare PECOS Information:
- PECOS PAC ID: 7911241856
- Enrollment ID: I20181204003299
Medical Identifiers
Medical identifiers for Brooke E Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1952789638 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | LRD.1256 (South Carolina) | Secondary |
363A00000X | Physician Assistant | 3074 (South Carolina) | 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. Brooke E 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 |
Brooke E Jackson, PA, RD, LD Po Box 751461, Charlotte, NC 28275-1461 Ph: (843) 792-6200 | Brooke E Jackson, PA, RD, LD 171 Ashley Ave, Charleston, SC 29425-8905 Ph: (843) 792-3020 |
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