SHELDON JACKSON (NPI# 1003829086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003829086 |
| Entity Type | Individual |
| Full Name | SHELDON JACKSON |
| Credential | PA |
| Practice Address |
1240 E Highway 193 Suite G-1 Layton UT 84040-8544 |
| Practice Telephone | 8017711331 |
| Mailing Telephone | 8017711331 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-12-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 6246293-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | RAILROAD MEDICARE | P00424201 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629479977 | Sheldon Jackson | Technician, Other | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2014-09-05 |
| Street Address |
1240 E HIGHWAY 193 SUITE G-1 |
| City | LAYTON |
| State | UT |
| Zip Code | 84040-8544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831590918 | Professional Dental LLC | Dentist | 1240 E Highway 193, Suite G-1, Layton, UT 84040-8544 | 2014-09-09 |
| 1033207535 | Randall Thomas Roberts | Chiropractor | 1240 E Highway 193, Suite G8, Layton, UT 84040-8544 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410947 | Creek Dental Group Meadowbrook LLC | Dentist | 1148 E Ut-193, Layton, UT 84040 | 2020-09-08 |
| 1902417629 | Christopher Luis Perez | Behavior Technician | 2940 Church Street, Suite 303, Layton, Davis, UT 84040 | 2020-08-14 |
| 1851939011 | Shaunell Young | Counselor | 2264 N 2650 E, 2264 N 2650 E, Layton, UT 84040 | 2019-12-18 |
| 1568929875 | Cassie Marie Decker | Behavior Technician | 2935 N 935 E, Layton, UT 84040 | 2019-02-22 |
| 1174035257 | Emily Reed | Behavior Technician | 935 E 2985 N, Layton, UT 84040 | 2017-10-30 |
| 1679008122 | Christopher Valdez | Behavior Technician | 935 East 2985 North, Layton, UT 84040 | 2017-04-21 |
| 1194175463 | Halie Checketts | Behavior Technician | 935 E 2985 S, Layton, UT 84040 | 2016-06-17 |
| 1609231125 | Katherine Pike Macias | Speech-Language Pathologist | 201 W Latyon Parkway, Layton, UT 84040 | 2015-12-28 |
| 1891164752 | Katherine Dean Turek | Social Worker | 476 West Heritage Park Blvd, Suite 220, Layton, UT 84040 | 2015-09-22 |
| 1790152189 | Alma Discuillo | Behavior Technician | 2490 N Church St, Layton, UT 84040 | 2015-09-01 |
| Find all providers in zip 84040 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740756816 | Jacob C Juarez | Physician Assistant | 2084 N. 1700 W., Suite A, Layton, UT 84041 | 2018-10-16 |
| 1508384256 | Deborah Elaine Alston | Physician Assistant | 2084 N 1700 W Ste A, Layton, UT 84041-1118 | 2017-09-01 |
| 1750818241 | Teri Junko Demille | Physician Assistant | 2084 N Robins Dr Ste A, Layton, UT 84041-1118 | 2017-05-16 |
| 1225482201 | Benjamin Clark Saxey | Physician Assistant | 2950 N Church St Ste 101, Layton, UT 84040-6504 | 2016-04-15 |
| 1689791709 | Jeffrey Scott Adams | Physician Assistant | 1231 N 75 W, Layton, UT 84041-2907 | 2007-03-23 |
| 1548282908 | Wesley Brandon Jones | Physician Assistant | 1600 W. Antelope Drive, Davis Hospital and Medical Center, Layton, UT 84041 | 2006-07-24 |
| 1336130889 | Jesse A Jorgensen | Physician Assistant | 1580 W Antelope Dr, Suite 100, Layton, UT 84041-1160 | 2005-11-03 |
| 1942290804 | Colleen Odonnell | Physician Assistant | 2132 N 1700 W Ste 230, Layton, UT 84041-7060 | 2005-10-24 |
| 1639161078 | Michael C Hawkins | Physician Assistant | 1660 Antelope Drive, Ste 225, Layton, UT 84041 | 2005-08-22 |
| 1639780745 | Darren Strong | Physician Assistant | 2121 N 1700 W, Layton, UT 84041-8803 | 2020-08-12 |
| Find all providers in LAYTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.