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

Individual provider Physician Assistant · NPI 1093940173

Jill Ann Spackman, PA is a Physician Assistant in Fort Campbell, Kentucky. Qualified in 2009, 17 years ago. Practices with Urgent Care Enterprise LLC, a 67-clinician group and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
17
Licensed in
CO
In the registry since
2009
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

650 Joel Dr
Fort Campbell, KY 42223
Phone: (270) 956-0336
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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 1086080 (CO)

Record details

NPI number1093940173
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 19, 2009
Last updated in NPPESJune 20, 2018
Mailing address650 Joel Dr, Fort Campbell, KY 42223-5318

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Urgent Care Enterprise Llc — 67 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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