Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackson Laboue, PA-C

Individual provider Physician Assistant · NPI 1205433885

Jackson Laboue, PA-C is a Physician Assistant in Richmond, Virginia. Qualified in 2020, 6 years ago. Practices with Orthovirginia Inc, a 570-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
6
Licensed in
VA
In the registry since
2020
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

5899 Bremo Rd Ste 100
Richmond, VA 23226-1935
Phone: (804) 288-8512
Fax: (804) 288-4552
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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 0110007683 (VA)

Record details

NPI number1205433885
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 6, 2020
Last updated in NPPESMarch 17, 2021
Certification dateMarch 17, 2021
Mailing address1115 Boulders Pkwy Ste 200, North Chesterfield, VA 23225-4067

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Orthovirginia Inc — 570 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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