COURTNEY MARIE JACKSON (NPI# 1013533926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013533926 |
| Entity Type | Individual |
| Full Name | COURTNEY MARIE JACKSON |
| Credential | MD |
| Practice Address |
750 Broadway Ste 350 Fort Wayne IN 46802-1412 |
| Practice Telephone | 2604232675 |
| Practice Fax Number | 2604236621 |
| Mailing Telephone | 2604232675 |
| Mailing Fax Number | 2604236621 |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2020-06-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 11021251A | IN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394938 | Courtney Jackson | Technician | 497 Candlestick Ct Apt B, Galloway, OH 43119-9216 | 2020-10-20 |
| 1063024842 | Courtney Ann Jackson | Technician | 5001 Mcclellan Hwy, Branchland, WV 25506-7704 | 2020-08-21 |
| 1912318429 | Courtney Jackson | Technician | 4134 Woodmont Dr, Houston, TX 77045-3330 | 2014-05-19 |
| 1760814396 | Courtney Danielle Jackson | Counselor | 534 E Basin St, Norristown, PA 19401-4068 | 2013-08-06 |
| 1487930723 | Courtney Jackson | Specialist/Technologist | 19424 Fallow Ln, Edinburg, TX 78542-1038 | 2011-11-01 |
| 1689824302 | Courtney Brooke Jackson | Naturopath | 511 Sw 10th Ave Ste 801, Portland, OR 97205-2709 | 2008-09-30 |
| 1063606846 | Courtney Lara Jackson | Counselor | 1801 Vincente St, San Francisco, CA 94116-2923 | 2007-09-05 |
| 1164029245 | Courtney Jackson | Speech-Language Pathologist | 65 Court St, Brooklyn, NY 11201-4916 | 2020-10-02 |
| 1457966509 | Courtney Tamara Jackson | Nurse Practitioner | 407 Cowart Ave, Valdosta, GA 31602-2635 | 2020-09-14 |
| 1508494600 | Courtney Elyse Jackson | Nurse Practitioner | 2508 Scottsville Rd Ste 104, Bowling Green, KY 42104-4400 | 2020-04-01 |
| Street Address |
750 BROADWAY STE 350 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46802-1412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144555855 | Paula A. Neuman | Psychologist | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2009-10-14 |
| 1598382293 | Luna Wahab | Family Medicine | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2020-06-29 |
| 1568088557 | Karla Allen | Family Medicine | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2020-06-25 |
| 1598381295 | Laura Marie Fulkerson | Family Medicine | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2020-06-19 |
| 1538784566 | Amber Denise Grandison | Family Medicine | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2020-06-16 |
| 1346865516 | Nicholas Daniel Panting | Family Medicine | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2020-06-12 |
| 1215551007 | Maria Manuela Snyder | Family Medicine | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2020-06-08 |
| 1902420789 | Carson Roberts | Family Medicine | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2020-06-08 |
| 1285258053 | Kenan Alibegovic | Family Medicine | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2020-06-08 |
| 1417571209 | Corey Aaron Snyder | Family Medicine | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2020-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568084416 | Renaissance Counseling Center,llc | Community/Behavioral Health | 1210 Guthrie St, Fort Wayne, IN 46802 | 2020-05-14 |
| 1699260182 | Tina Huffman Counseling Services LLC | Clinic/Center | 2323 111 W. Berry St., Fort Wayne, IN 46802 | 2018-06-27 |
| 1669879664 | Neighborhood Health Clinics, Inc | Clinic/Center | 1721 S Calhoun St, Fort Wayne, IN 46802 | 2014-11-20 |
| 1205272168 | Tyler Jerome Kimmel | Dentist | 1717 S. Calhoun Street, Fort Wayne, IN 46802 | 2013-05-20 |
| 1174899405 | Hearcare Connection, Inc. | Audiologist | 130 W Main St Ste 150, Fort Wayne, IN 46802 | 2012-03-30 |
| 1801114533 | Hoosier Sports & Chiropractic LLC | Chiropractor | 122 W Wayne Street, Fort Wayne, IN 46802 | 2010-05-05 |
| 1891912523 | Krista Lohmar | Speech-Language Pathologist | 3340 North Washington Road, Ft. Wayne, IL 46802 | 2007-04-20 |
| 1811047608 | Catholic Charities of The Diocese of Fort Wayne-south Bend, Inc. | Counselor | 915 South Clinton, Fort Wayne, IN 46802 | 2007-01-12 |
| 1548323801 | Clifford T Salk | Dentist | 122 W Washington Blvd, Fort Wayne, IN 46802 | 2006-12-18 |
| 1720155492 | Kristina Wise | Social Worker | 203 W Wayne St Ste 317, Fort Wayne, IN 46802 | 2006-11-29 |
| Find all providers in zip 46802 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760912026 | Christina A Tatara | Family Medicine | 6511 E State Blvd, Fort Wayne, IN 46815-7026 | 2017-06-19 |
| 1700317633 | Robert Campbell | Family Medicine | 7411 Hope Dr, Fort Wayne, IN 46815-5687 | 2017-03-22 |
| 1487196424 | American Vein Institute LLC | Family Medicine | 10020 Dupont Circle Ct Ste 140, Fort Wayne, IN 46825-1621 | 2016-11-08 |
| 1831547124 | Anna Menze | Family Medicine | 10307 Dupont Circle Dr W Ste A, Fort Wayne, IN 46825-1633 | 2016-05-27 |
| 1407203672 | Credo Health Group, LLC | Family Medicine | 10228 Dupont Circle Dr E # 100b, Fort Wayne, IN 46825-1611 | 2016-05-18 |
| 1649625104 | Gabrielle Paloma Acquaro | Family Medicine | 7806 W Jefferson Blvd Ste E, Fort Wayne, IN 46804-4180 | 2016-05-03 |
| 1720491731 | John E Marx | Family Medicine | 1007 W Rudisill Blvd, Fort Wayne, IN 46807-2170 | 2014-06-06 |
| 1457763252 | Amy Simpson | Family Medicine | 1818 Carew St Ste 120, Fort Wayne, IN 46805-4764 | 2014-05-28 |
| 1932536083 | Clifford James Shultz | Family Medicine | 2616 Covington Pointe Trl, Fort Wayne, IN 46804-2773 | 2013-10-03 |
| 1164860086 | Andrew J Mullally | Family Medicine | 10050 Auburn Park Dr, Fort Wayne, IN 46825-2389 | 2013-06-13 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46802 |
Please comment or provide details below to improve the information on COURTNEY MARIE JACKSON.
| 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.