Derrell Jackson, PA-C
NPI 1104072297 · Physician Assistant · Colonial Heights, VA
Derrell Jackson, PA-C is a Physician Assistant provider in Colonial Heights, VA (NPI 1104072297).
Provider details
- NPI number
- 1104072297
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 0110002804 (VA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-08-08
- Last updated
- 2010-05-26
Frequently asked questions
- What is Derrell Jackson's NPI number?
- Derrell Jackson's National Provider Identifier (NPI) is 1104072297, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Derrell Jackson's specialty?
- Derrell Jackson is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Derrell Jackson located?
- Derrell Jackson's practice location on file with NPPES is 436 Claremont Ct, Colonial Heights, VA 23834-1765.
- What is Derrell Jackson's phone number?
- The practice phone number listed in the NPPES registry for Derrell Jackson is (804) 526-2121.
- Is Derrell Jackson's NPI active?
- Yes — Derrell Jackson's NPI (1104072297) is active in the NPPES registry as of the last update on 2010-05-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.