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Active NPI 1588373716 Individual Practitioner Female Practitioner

Kodi Long Jackson , PA

Physician Assistant • Jackson, MS

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Kodi Jackson, PA is a certified Physician Assistant practicing in Jackson, MS. With approximately 4 years of clinical experience since completing medical education in 2022, Kodi Jackson delivers high-quality medical care to the local community at 969 LAKELAND DR.

Kodi Jackson maintains professional affiliations with Rh Mississippi Hospitalist Medicine Llc, St. Dominic Medical Associates Llc, St. Dominic Jackson Memorial and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, anticoagulant management of patient taking warfarin, hospital discharge day management, more than. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

969 Lakeland Dr

Jackson, MS 392164606

Telephone 6012003631
Fax 6012000159
Associated Practice Facility / Clinic
🏢 Jpa Pathology, P.a. Facility NPI 1104824309

Medicare Profile & Education

Medical School

Other

Graduation Year

2022

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Jackson, MS

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
4 Yrs -2.4 yrs vs City Avg
City Avg: 6.4 Yrs
State Avg: 8.9 Yrs
Regional Practice Density
66 Specialists

Practicing in Jackson, MS (343 Statewide)

Telehealth Adoption Rate
4.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
58.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jackson (4 Years) 4 Yrs
Jackson Specialty Average (6.4 Years) 6.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes
124 70 $172.00 $81.12
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
112 77 $120.00 $60.93
93793 Anticoagulant management of patient taking warfarin
52 31 $22.00 $8.77
99239 Hospital discharge day management, more than 30 minutes
45 45 $195.00 $80.53
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
38 38 $352.79 $131.55
85610 Blood test, clotting time
29 21 $18.00 $4.20

Medical Specialties & State Licenses

CMS Verified: 2025-11-03
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

St. Dominic Medical Associates Llc

106 Highland Way, Madison, MS 391106933

St. Dominic Jackson Memorial

969 Lakeland Dr, Jackson, MS 392164606

Phone: 6013646175

St. Dominic Medical Associates Llc

969 Lakeland Dr, Jackson, MS 392164606

Phone: 6012003100

Rh Mississippi Hospitalist Medicine Llc

969 Lakeland Dr, Jackson, MS 392164606

Phone: 6012002000

Secondary Practice Locations

971 Lakeland Dr Ste 657

Jackson, MS 392164608

Phone: 6012002780

971 Lakeland Dr Ste 356

Jackson, MS 392164607

Phone: 6012004644

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Casey Baine , ACAGNP

Nurse Practitioner - Acute Care

NPI 1245835263
Wendy Phillips , FNP-C

Nurse Practitioner

NPI 1316783293

Family Nurse Practitioner (Certified)

Kristen Degelman

Nurse Practitioner - Family

NPI 1437694320
Margaret Mosley , NP-C

Nurse Practitioner - Family

NPI 1508043951

Nurse Practitioner (Certified)

Latasha Collins , CFNP

Nurse Practitioner - Family

NPI 1780089649
Ann Oliver , APRN

Nurse Practitioner

NPI 1811865728

Advanced Practice Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location March 06, 2025

Registered at 969 LAKELAND DR, JACKSON, MS 392164606 (Tel: 6012002280)

📍
Updated Practice Location March 06, 2024

Registered at 971 LAKELAND DR STE 356, JACKSON, MS 392164607 (Tel: 6012004644)

📍
Updated Business Mailing Address March 06, 2024

Registered at 5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 708166038 (Tel: 6012004644)

👤
Provider Name / Credentials Updated March 06, 2024

Recorded as KODI JACKSON, PA

📍
Updated Practice Location January 13, 2023

Registered at 969 LAKELAND DR, JACKSON, MS 392164606 (Tel: 6012005907)

📍
Updated Business Mailing Address January 13, 2023

Registered at 208 HAWTHORNE DR, MADISON, MS 391109334 (Tel: 6019064389)

NPI Profile Active November 16, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location November 16, 2022

Registered at 205 PECAN CV, JACKSON, MS 392099583 (Tel: 6019064389)

📍
Updated Business Mailing Address November 16, 2022

Registered at 205 PECAN CV, JACKSON, MS 392099583

👤
Provider Name / Credentials Updated November 16, 2022

Recorded as KODI LONG, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 16, 2022

Physician Assistant

🟢
Initial NPI Registration & Enumeration November 16, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1588373716
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 16, 2022
Last Update: November 03, 2025
Sole Proprietor: No

Mailing Address

5959 S Sherwood Forest Blvd

Baton Rouge, LA 708166038

Phone: 6012004644

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.