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

Jackson Roberson, PA-C

Individual provider Physician Assistant · NPI 1821831223

Jackson Roberson, PA-C is a Physician Assistant in Charlotte, North Carolina. Qualified in 2024, 2 years ago. Practices with Carolina Medicorp Enterprises LLC, a 185-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
2
Licensed in
NC
In the registry since
2024
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

501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211-0035
Phone: (704) 377-2424
Fax: (704) 377-2687
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 200 Hawthorne Ln, Charlotte, NC 28204-2515 — (704) 384-4000
  • 13129 S Tryon St Ste 120, Charlotte, NC 28278-7915 — (980) 337-4662

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-15256 (NC)

Record details

NPI number1821831223
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 14, 2024
Last updated in NPPESDecember 5, 2025
Certification dateDecember 5, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Carolina Medicorp Enterprises Llc — 185 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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