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

Stacie Jackson, PA

Individual provider Physician Assistant · NPI 1770248668

Stacie Jackson, PA is a Physician Assistant in Jacksonville, Florida. Graduated from Nova Southeastern College of Osteo Medicine in 2021, 5 years ago. Practices with Hughston Clinic Southeast PC, a 48-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
5
Trained at
Nova Southeastern College of Osteo Medicine
Licensed in
FL
In the registry since
2021
Specialties on file
2
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

3627 University Blvd S Ste 550
Jacksonville, FL 32216-7401
Phone: (904) 379-5986
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5540 Ne 4th St, Ocala, FL 34470-9512 — (352) 547-0878

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA9115246 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 9115246 (FL)

Record details

NPI number1770248668
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 4, 2021
Last updated in NPPESMarch 10, 2025
Certification dateMarch 10, 2025
Mailing addressPo Box 370, Fortson, GA 31808-0370

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolNOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduated 2021 (5 years in practice)
Group practice Hughston Clinic Southeast Pc — 48 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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