Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Sharonda Latecha Jackson, PA-S

Individual provider Physician Assistant · NPI 1568060853

Sharonda Latecha Jackson, PA-S is a Physician Assistant in Chapel Hill, North Carolina. Qualified in 2022, 4 years ago. Practices with Clinic Services of California Medical Group Inc, a 66-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
4
Licensed in
NC
In the registry since
2020
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Practice location Address checks out

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone: (984) 974-4721
Fax: (919) 966-9533
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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 0010-12298 (NC)

Record details

NPI number1568060853
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-S
Sole proprietorNo
NPI enumeratedOctober 9, 2020
Last updated in NPPESJanuary 5, 2023
Certification dateJanuary 5, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Clinic Services Of California Medical Group Inc — 66 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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