Kenzie Jackley, PHYSICIAN ASSISTANT
NPI 1396142568 · Physician Assistant · Edina, MN
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kenzie Jackley, PHYSICIAN ASSISTANT is a Physician Assistant provider in Edina, MN (NPI 1396142568).
Provider details
- NPI number
- 1396142568
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PHYSICIAN ASSISTANT
- Sex
- Female
- Sole proprietor
- No
- License
- 11821 (MN)
Specialties & taxonomies
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
11 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
- 2014-12-03
- Last updated
- 2020-11-03
- Certified
- 2020-11-03
Frequently asked questions
- What is Kenzie Jackley's NPI number?
- Kenzie Jackley's National Provider Identifier (NPI) is 1396142568, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kenzie Jackley's specialty?
- Kenzie Jackley is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Kenzie Jackley located?
- Kenzie Jackley's practice location on file with NPPES is 6700 France Ave S, Edina, MN 55435-1902.
- What is Kenzie Jackley's phone number?
- The practice phone number listed in the NPPES registry for Kenzie Jackley is (952) 345-3000.
- Does Kenzie Jackley accept Medicare?
- Kenzie Jackley is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kenzie Jackley's NPI active?
- Yes — Kenzie Jackley's NPI (1396142568) is active in the NPPES registry as of the last update on 2020-11-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.