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Active NPI 1104283365 Individual Practitioner Female Practitioner

Kaylyn A Jackson , PA

Physician Assistant • Roanoke, VA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Kaylyn Jackson, PA is a certified Physician Assistant practicing in Roanoke, VA. With approximately 11 years of clinical experience since completing medical education in 2015, Kaylyn Jackson delivers high-quality medical care to the local community at 2001 CRYSTAL SPRING AVE SW STE 201.

Kaylyn Jackson is affiliated with Carilion Medical Center and accepts Medicare assignment.

Frequently performed procedures and clinical services include harvest of veins for coronary artery bypass procedure using an endoscope, coronary artery bypass using artery graft, 1 graft, coronary artery bypass using vein or artery graft, 2 grafts. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2001 Crystal Spring Ave Sw Ste 201

Roanoke, VA 240142465

Telephone 5408530100
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2015

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Roanoke, VA

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
11 Yrs +2.6 yrs vs City Avg
City Avg: 8.4 Yrs
State Avg: 10.5 Yrs
Regional Practice Density
301 Specialists

Practicing in Roanoke, VA (4432 Statewide)

Telehealth Adoption Rate
13.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
95.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jackson (11 Years) 11 Yrs
Roanoke Specialty Average (8.4 Years) 8.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
33508 Harvest of veins for coronary artery bypass procedure using an endoscope
12 12 $49.00 $2.17
33533 Coronary artery bypass using artery graft, 1 graft
11 11 $5715.00 $257.94

Medical Specialties & State Licenses

CMS Verified: 2025-08-15
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License VA 0110005201

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.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License MI 5601011711

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.

Physician Assistant - Surgical

NUCC Taxonomy Code: 363AS0400X

State License VA 0110-005201

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1104283365 (VA)

Hospital & Practice Group Affiliations

Carilion Medical Center

1906 Belleview Ave Se, Roanoke, VA 240141838

Phone: 5409817000

Carilion Medical Center

2017 S Jefferson St, Roanoke, VA 240142419

Phone: 5409817128

Carilion Medical Center

2017 Jefferson St Sw, Roanoke, VA 240142419

Phone: 5409817925

Secondary Practice Locations

1100 E Michigan Ave

Jackson, MI 492011847

Phone: 5172054800

1221 Lee St, 2nd Floor

Charlottesville, VA 229080001

Phone: 4349245052

Practice Associates & Co-Workers

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

40 Associated Practitioners
Sarah Guzinski-Homcha

Physician Assistant - Surgical

NPI 1003243882
Beverly Jones , NP

Nurse Practitioner - Critical Care Medicine

NPI 1013122522

Nurse Practitioner

Laura Angle , FNP-C

Nurse Practitioner - Family

NPI 1033801436

Family Nurse Practitioner (Certified)

Carmen Salmon , PA-C

Physician Assistant

NPI 1053644245

Physician Assistant (Certified)

Katherine Gill , NP

Nurse Practitioner - Acute Care

NPI 1063988681

Nurse Practitioner

Lisa Zettler

Nurse Practitioner - Family

NPI 1083247555

Career & Practice History Timeline

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

16 Historical Events
📍
Updated Practice Location August 15, 2025

Registered at 2001 CRYSTAL SPRING AVE SW STE 201, ROANOKE, VA 240142465 (Tel: 5408530100)

📍
Updated Business Mailing Address August 15, 2025

Registered at 213 S JEFFERSON ST STE 1006, ROANOKE, VA 240111713

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 15, 2025

Physician Assistant (License #5601011711 in MI)

📍
Updated Practice Location July 11, 2023

Registered at 1100 E MICHIGAN AVE, JACKSON, MI 492011847 (Tel: 5172054800)

📍
Updated Business Mailing Address July 11, 2023

Registered at 1 FORD PL STE 3A, DETROIT, MI 482023450 (Tel: 3138764806)

NPI Profile Active January 26, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location January 26, 2017

Registered at 1221 LEE ST, 2ND FLOOR, CHARLOTTESVILLE, VA 229080001 (Tel: 4349245052)

📍
Updated Business Mailing Address January 26, 2017

Registered at PO BOX 9007, CHARLOTTESVILLE, VA 229069007

👤
Provider Name / Credentials Updated January 26, 2017

Recorded as KAYLYN JACKSON, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 26, 2017

Physician Assistant (License #0110-005201 in VA)

NPI Profile Active February 24, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location February 24, 2016

Registered at 1221 LEES ST, 2ND FLOOR, CHARLOTTESVILLE, VA 229080001 (Tel: 4349245052)

📍
Updated Business Mailing Address February 24, 2016

Registered at PO BOX 9007, CHARLOTTESVILLE, VA 229069007

👤
Provider Name / Credentials Updated February 24, 2016

Recorded as KAYLYN PRICE, PA.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 24, 2016

Physician Assistant (License #0110-005201 in VA)

🟢
Initial NPI Registration & Enumeration January 19, 2016

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: 1104283365
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 19, 2016
Last Update: August 15, 2025
Sole Proprietor: No

Mailing Address

213 S Jefferson St Ste 1006

Roanoke, VA 240111713

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.