Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Carly Anne Jackson, PA-C

Individual provider Physician Assistant · NPI 1053696971

Carly Anne Jackson, PA-C is a Physician Assistant in Rockford, Illinois. Graduated from Middlesex University School of Medicine in 2009, 17 years ago. Practices with Mid-Columbia Medical Center, a 94-clinician group and accepts Medicare assignment.

Years since qualifying
17
Trained at
Middlesex University School of Medicine
In the registry since
2011
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

324 Roxbury Rd
Rockford, IL 61107-5090
Phone: (815) 398-9491
Fax: (815) 381-7333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1053696971
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 12, 2011
Last updated in NPPESJune 5, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolMIDDLESEX UNIVERSITY SCHOOL OF MEDICINE
Graduated 2009 (17 years in practice)
Group practice Mid-Columbia Medical Center — 94 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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