Individual Healthcare Provider
Kimberly Shelley Jackson, M.D.
Provider's NPPES record last updated: January 23, 2019
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1558318527
- Primary Specialty
- Family Medicine
- Practice Location
- Daniel Island, South Carolina
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 20, 2026, 11:36 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Family Medicine
Allopathic & Osteopathic Physicians
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Taxonomy code 207Q00000X
Provider-Reported License Information
- Family Medicine (South Carolina)
- 18009
Practice Locations
Practice Location
864 Island Park Dr Ste 101
Daniel Island, South Carolina 29492-7446
Phone: (843) 876-7975
Additional Practice Location
1210 Main St
Conway, South Carolina 29526-3633
Phone: (843) 488-1700
Fax: (843) 488-4301
Additional Practice Location
800 E Cheves St Ste 200
Florence, South Carolina 29506-2651
Phone: (843) 662-1502
Fax: (843) 678-3611
Additional Practice Location
1113 Parkwest Blvd
Mt Pleasant, South Carolina 29466
Phone: (843) 876-1445
Record Information
- Enumeration Date
- May 27, 2006
- Provider's NPPES Record Last Updated
- January 23, 2019
- NPISignal NPPES Dataset
- August 2026
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