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

Mishi Kavon Jackson, MD

Individual provider Family Medicine Physician · NPI 1215006192

Mishi Kavon Jackson, MD is a Family Practice in Kernersville, North Carolina. Graduated from University of Mississippi School of Medicine in 1993, 33 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
33
Trained at
University of Mississippi School of Medicine
Licensed in
NC
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1471 Jag Branch Blvd Unit 103
Kernersville, NC 27284-6963
Phone: (336) 515-7410
Fax: (336) 515-7419
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 291 Broad St, Kernersville, NC 27284-2932 — (336) 993-8181

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 200600012 (NC)

Record details

NPI number1215006192
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 7, 2006
Last updated in NPPESMarch 7, 2023
Certification dateMarch 7, 2023

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 1993 (33 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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