ATIBA DIARRA JACKSON (NPI# 1033329990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033329990 |
| Entity Type | Individual |
| Full Name | ATIBA DIARRA JACKSON |
| Credential | M.D. |
| Practice Address |
4160 Little York Rd Ste 10 Dayton OH 45414-5803 |
| Practice Telephone | 9374159100 |
| Practice Fax Number | 9374159191 |
| Mailing Telephone | 9374159100 |
| Mailing Fax Number | 9374159191 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2016-09-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 35.089443 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
4160 LITTLE YORK RD STE 10 |
| City | DAYTON |
| State | OH |
| Zip Code | 45414-5803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598764391 | Cardiology Specialists of Dayton Inc. | Internal Medicine | 4160 Little York Rd, Ste. 20, Dayton, OH 45414-5800 | 2005-07-14 |
| 1538532825 | Amy Birkemeier | Physical Therapist | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2015-11-09 |
| 1154701837 | Zachary Baum | Registered Nurse | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2015-06-08 |
| 1578942728 | Rachel Lloyd | Physical Therapist | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2015-05-20 |
| 1508267279 | Lauren Rode | Physician Assistant | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2014-09-11 |
| 1194149955 | Kathleen Walker | Occupational Therapist | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2014-02-13 |
| 1821338336 | Jcc, LLC | Clinic/Center | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2013-02-20 |
| 1053661926 | Stephanie Jae Buehler | Occupational Therapist | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2012-09-18 |
| 1104197318 | Holly Ann Wolters | Physician Assistant | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2012-01-19 |
| 1598047664 | Brigitte Nicole Eric | Physical Therapist | 4160 Little York Rd, Suite 10, Dayton, OH 45414-5800 | 2011-09-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578047916 | Amanda Adkins | Counselor | 4977 Northcutt Pl, Dayton, OH 45414 | 2018-09-21 |
| 1477062180 | Andria Shoebridge | Case Manager/Care Coordinator | 7695 Poe Ave., Dayton, OH 45414 | 2017-09-26 |
| 1164826871 | Joana's | Custodial Care Facility | 323 Timberlake Drive, Dayton, OH 45414 | 2014-10-09 |
| 1376956839 | Shanata Rankins | Home Health Aide | 3252 Ridge Ave, Dayton, OH 45414 | 2014-06-03 |
| 1689086845 | Michelle Laree Cargle-adams | Licensed Practical Nurse | 6217 Miller Lane, Vandalia, OH 45414 | 2014-05-22 |
| 1962847236 | Tessa Skeens | Home Health | 1914 Palisades Dr, Dayton, OH 45414 | 2013-05-01 |
| 1053661397 | Jeffrey Michael Pope | Pharmacist | 3700 North Dixie Highway, Dayton, OH 45414 | 2012-09-13 |
| 1174871784 | Elizabeth Long | Counselor | 3821 Little York Rd., Dayton, OH 45414 | 2012-08-29 |
| 1265709885 | Eddie Dudley | Pharmacist | 5651 Dixie Ave, Dayton, OH 45414 | 2011-11-28 |
| 1568774743 | Martin Nicholas Kanetsky | Dentist | 6800 N. Dixie Dr., Dayton, OH 45414 | 2010-07-05 |
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| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639410145 | David Francis Paul | Orthopaedic Surgery | 40 Farrington Way, Dayton, ME 04005-7647 | 2013-03-07 |
| 1871821371 | Jennifer Lynn Jerele | Orthopaedic Surgery | 30 E Apple St Ste 2200, Dayton, OH 45409-2939 | 2009-11-23 |
| 1760508022 | Brian Keith Hutchinson | Orthopaedic Surgery | 128 E Apple St Rm 2830, Dayton, OH 45409-2902 | 2007-03-21 |
| 1508967316 | Jonathan Joseph Paley | Orthopaedic Surgery | 5491 Far Hills Avenue, Dayton, OH 45429 | 2006-09-26 |
| 1235147422 | Henry Lee King | Orthopaedic Surgery | 5341 Dushore Dr, Dayton, OH 45427-2731 | 2006-08-03 |
| 1356312565 | Kenneth P Pohl | Orthopaedic Surgery | 5692 Far Hills Ave, Suite 4, Dayton, OH 45429-2239 | 2006-01-27 |
| 1942281308 | Thomas M Cook | Orthopaedic Surgery | 7980 N Main St., Dayton, OH 45415-2328 | 2005-11-10 |
| 1356346985 | Frank Peter Mannarino | Orthopaedic Surgery | 3205 Woodman Dr, Dayton, OH 45420-1143 | 2005-06-20 |
| 1376007906 | Dustin Young | Orthopaedic Surgery | 405 W Grand Ave, Dayton, OH 45405-7538 | 2019-01-28 |
| 1245694371 | Trenden L Flanigan | Orthopaedic Surgery | 30 E Apple St Ste 2200, Dayton, OH 45409-2939 | 2016-04-05 |
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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.