Shannon Jackson, PA-C
Shannon Jackson, PA-C is a Physician Assistant in Mishawaka, Indiana. Qualified in 2018, 8 years ago. Practices with Saint Joseph Regional Medical Center Inc, a 141-clinician group and accepts Medicare assignment. Licensed in Indiana and Michigan.
- Years since qualifying
- 8
- Licensed in
- IN, MI
- In the registry since
- 2018
- Specialties on file
- 2
What do these letters mean?
- PA-C — Physician Assistant, Certified
- A physician assistant who holds current national certification.
Practice location Address checks out
611 E Douglas Rd Ste 203Mishawaka, IN 46545-1467
Phone: (574) 335-6640
Fax: (574) 335-0621
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 10005009A (IN) |
|---|---|
| Physician Assistant | Taxonomy 363A00000X · Licence 5601011128 (MI) |
Record details
| NPI number | 1134616584 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | PA-C |
| Sole proprietor | No |
| NPI enumerated | April 20, 2018 |
| Last updated in NPPES | October 14, 2025 |
| Certification date | October 14, 2025 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2018 (8 years in practice) |
| Group practice | Saint Joseph Regional Medical Center Inc — 141 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 3 on file with Medicare |
Other providers in Mishawaka
-
John L Kittredge, PA
3740 Edison Lakes Pkwy, Mishawaka, IN 46545-3474 · (574) 252-4150
-
Mrs. Diana E Perez - Solano, PA-C
611 E Douglas Rd Ste 207, Mishawaka, IN 46545-1465 · (574) 335-6850
-
Megan Michelle Poole, PA-C
5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 · (574) 335-5000
-
Julia Marie Tarpley, PAC
270 E Day Rd Ste 280, Mishawaka, IN 46545-3452 · (574) 271-0268