Derrell Glenn Jackson, PA-C
Physician Assistant · Colonial Heights, VA
Derrell Glenn Jackson, PA-C is a physician assistant with a practice address in Colonial Heights, Virginia, and NPI 1104072297, issued on Aug 8, 2008. Check the license (Virginia 0110002804, as entered in NPPES) with the Virginia board that licenses this profession; the federal record below is the public data PlainDoctor holds for this provider.
- Name
- Derrell Glenn Jackson
- Credential
- PA-C
- Primary taxonomy
- Physician Assistant 363A00000X
- License number
- 0110002804 VA
Self-reported in NPPES; status is on the state search - Practice location
- 436 Claremont CT, Colonial Heights, VA 23834
- Phone
- (804) 526-2121
- Enumerated
- Aug 8, 2008
- Record last updated
- May 26, 2010 (not updated in 16 years: call before relying on the address or phone)
- Fax
- (804) 520-2617
- Medicaid ID
- 1104072297 VA
- Entity
- Type 1 · individual
8 nearest physician assistant records → All 4,408 in Virginia → Look up another NPI →
Also registered at 436 Claremont CT
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Clark Hunt, MDFamily Medicine Physician1316937162
- James Ross, M.D., MPHInternal Medicine Physician1932157757
Verify Derrell Glenn Jackson in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Virginia board licenses this profession
Search for license 0110002804Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Derrell Glenn Jackson among 4,408 physician assistant records in Virginia
Derrell Glenn Jackson, PA-C is one of 4,408 physician assistant records with a practice address in Virginia. 78% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does not. Its NPI, issued in 2008, is newer than 18% of them.
- NPI issued2008 · 18% of these records are older, 79% newer
- In a Medicare fileNo · 78% of these records are
- In the CMS Doctors and Clinicians fileNo · 66% of these records are
- Record last updated2010 · 33% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 363A00000X and a Virginia practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
15 physician assistant records list a practice address in Colonial Heights
They are 15 of the 459 NPPES records with a practice address in Colonial Heights, and 4,408 physician assistant records in Virginia. No Medicare prescribing, quality score, industry payment or hospital affiliation is published for this NPI.
All 4,408 in Virginia → Every provider in Colonial Heights → Physician Assistant nationwide →
The 8 physician assistant records with the nearest ZIP codes
- Richard Acevedo, PHYSICIAN ASSISTANTColonial Heights, VA 238341861409187
- Kris Clark, PAColonial Heights, VA 238341154318624
- Koren Cooper, PA-CSouth Chesterfield, VA 238341881947893
- Natale Fatchet, PA-CColonial Heights, VA 238341346424900
- Ignatius HallPetersburg, VA 238341982979464
- Carolyn Herrera, PA-CColonial Heights, VA 238341477834455
- John Impastato, PA-CColonial Heights, VA 238341053319590
- Jeremy Joo, PA-CColonial Heights, VA 238341215711890
Common questions
What is Derrell Glenn Jackson, PA-C's NPI number?
Derrell Glenn Jackson, PA-C's National Provider Identifier (NPI) is 1104072297, issued on Aug 8, 2008. An NPI identifies a provider in billing; it is not a license.
Where is Derrell Glenn Jackson, PA-C located?
The NPPES record lists a practice address at 436 Claremont CT, Colonial Heights, VA, 23834. Phone: (804) 526-2121. Providers update this record themselves, so call before visiting.
How can I verify Derrell Glenn Jackson, PA-C's license?
NPPES lists Virginia license number 0110002804, as entered by the provider. Search the Virginia board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.