Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Brianna Shanice Jackson, PA-C

Individual provider Physician Assistant · NPI 1922679489

MS. Brianna Shanice Jackson, PA-C is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2021, 5 years ago. Practices with Advantage Physical Therapy and Sports Rehab, LLC, a 286-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
5
Licensed in
WI
In the registry since
2021
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

2555 N Martin Luther King Dr
Milwaukee, WI 53212-2709
Phone: (414) 372-8080
Fax: (414) 562-8084
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8200 W Silver Spring Dr, Milwaukee, WI 53218-2552 — (414) 760-3900

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5587-23 (WI)

Record details

NPI number1922679489
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 6, 2021
Last updated in NPPESJuly 3, 2024
Certification dateJuly 3, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Advantage Physical Therapy And Sports Rehab, Llc — 286 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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