Dominique Latia Jackson, PA-C - Physician Assistant in Shelby, NC

Dominique Latia Jackson, PA-C is a Physician Assistant based in Shelby, North Carolina. Dominique Latia Jackson is licensed to practice in North Carolina (license number 0010-14318) and her current practice location is 1760 E Dixon Blvd, Shelby, North Carolina. She can be reached at her office (for appointments etc.) via phone at (704) 480-9344.

NPI number for Dominique Latia Jackson is 1841054392 and her current mailing address is 200 E 2nd Ave, Gastonia, North Carolina. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1841054392.

Contact Information

Dominique Latia Jackson, PA-C
1760 E Dixon Blvd,
Shelby, NC 28152-6948
(704) 480-9344
(704) 482-8494

Map and Direction




Provider's Profile

Full NameDominique Latia Jackson
GenderFemale
SpecialityPhysician Assistant
Location1760 E Dixon Blvd, Shelby, North Carolina
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1841054392
  • Provider Enumeration Date: 02/06/2024
  • Last Update Date: 08/27/2024

Medical Identifiers

Medical identifiers for Dominique Latia Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1841054392NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 0010-14318 (North Carolina)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dominique Latia Jackson is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dominique Latia Jackson, PA-C
200 E 2nd Ave,
Gastonia, NC 28052-4358

Ph: () -
Dominique Latia Jackson, PA-C
1760 E Dixon Blvd,
Shelby, NC 28152-6948

Ph: (704) 480-9344

Reviews and Comments


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Phone: 704-481-1142    Fax: 704-481-8305
Caitlin Colleen Christ, PA
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Mr. Paul A Claroni, PA
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Medicare: Medicare Enrolled
Practice Location: 808 Schenck St, Shelby, NC 28150
Phone: 704-484-3647    Fax: 704-484-3260
Mrs. Christina Duffy Hayes, PAC
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Medicare: Not Enrolled in Medicare
Practice Location: 935 Wyke Rd, Shelby, NC 28150
Phone: 704-481-1142    Fax: 704-481-8305

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.