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

Kaylyn A Jackson, PA

Individual provider Physician Assistant · NPI 1104283365

Kaylyn A Jackson, PA is a Physician Assistant in Roanoke, Virginia. Qualified in 2015, 11 years ago. Practices with Carilion Medical Center, a 951-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Michigan and Virginia.

Years since qualifying
11
Licensed in
MI, VA
In the registry since
2016
Specialties on file
3
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

2001 Crystal Spring Ave SW Ste 201
Roanoke, VA 24014-2465
Phone: (540) 853-0100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1100 E Michigan Ave, Jackson, MI 49201-1847 — (517) 205-4800
  • 1221 Lee St, Charlottesville, VA 22908-0001 — (434) 924-5052

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110005201 (VA)
Physician Assistant Taxonomy 363A00000X · Licence 5601011711 (MI)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 0110-005201 (VA)

Record details

NPI number1104283365
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 19, 2016
Last updated in NPPESAugust 15, 2025
Certification dateAugust 15, 2025
Mailing address213 S Jefferson St Ste 1006, Roanoke, VA 24011-1713

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Carilion Medical Center — 951 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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