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

Individual provider Physician Assistant · NPI 1457567265

Carol Mackenzie Jackson, PA-C is a Physician Assistant in Philadelphia, Pennsylvania. Qualified in 2004, 22 years ago. Practices with Temple Faculty Practice Plan Inc, a 1,314-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
22
Licensed in
PA
In the registry since
2007
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

333 Cottman Ave
Philadelphia, PA 19111-2434
Phone: (215) 728-6900
Fax: (215) 728-2773
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA052046 (PA)

Record details

NPI number1457567265
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 16, 2007
Last updated in NPPESDecember 1, 2022
Certification dateDecember 1, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Temple Faculty Practice Plan Inc — 1314 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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