Lexie Catherine Grimm Jackowski, PA
Physician Assistant in Cumberland, MD. Individual provider (NPI-1).
NPI number1689317596
StatusActive
Last updated in NPPESMar 20, 2026
Details
- NPI
- 1689317596
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Lexie Catherine Grimm Jackowski
- Credential
- PA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 18, 2022
- Certification date
- Mar 20, 2026
- Last updated
- Mar 20, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
1050 W Industrial Blvd Ste 17Cumberland, MD 21502-4331
Phone 240-964-9300 · Fax 240-964-9310
Mailing address
13406 Pershing StCumberland, MD 21502-5312
Phone 301-471-4063
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 35 Physician Assistant providers in Cumberland · All 1,553 providers in Cumberland
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