DR. MARTHA A JACKSON (NPI# 1053372946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053372946 |
| Entity Type | Individual |
| Full Name | DR. MARTHA A JACKSON |
| Credential | DPM |
| Practice Address |
2501 Crestwood Rd Suite 101 North Little Rock AR 72116-7615 |
| Practice Telephone | 5017714785 |
| Practice Fax Number | 5017714787 |
| Mailing Telephone | 5017714785 |
| Mailing Fax Number | 5017714787 |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2020-07-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 87 | AR | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | FEP BCBS | 56243 | 01 |
| CIGNA | 9468520001 | 01 | |
| PALMETTO DME | 0580220001 | 01 | |
| AR | 110420717 | 05 | |
| AR | HEALTH ADVANTAGE | 56243 | 01 |
| UNITED HEALTH CARE | 2720028 | 01 | |
| AR | FIRST SOURCE | 56243 | 01 |
| AR | QUAL CHOICE | 16253000040 | 01 |
| AR | AR BCBS | 56243 | 01 |
| AETNA | 5997156 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386862605 | Martha Sue Jackson | Specialist | 888 Oakwood Rd, Suite 220, Charleston, WV 25314-2000 | 2007-04-23 |
| 1720137516 | Martha Ann Jackson | Nurse Practitioner | 950 Winter St, Suite 3800, Waltham, MA 02451-1424 | 2007-01-09 |
| 1932261260 | Martha Jackson | Physical Therapist | 5555 Glendon Ct, Dublin, OH 43016-3249 | 2006-12-14 |
| Street Address |
2501 CRESTWOOD RD SUITE 101 |
| City | NORTH LITTLE ROCK |
| State | AR |
| Zip Code | 72116-7615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750617486 | Michael Lynn Quick | Dentist | 2501 Crestwood Rd, Suite 303, North Little Rock, AR 72116-6864 | 2009-10-31 |
| 1447495049 | Steven F. Molpus, D.d.s., P.l.c. | Clinic/Center | 2501 Crestwood Rd, Suite 302, North Little Rock, AR 72116-6864 | 2008-12-10 |
| 1194989087 | Dale E. Colclasure, D. D. S. | Dentist | 2501 Crestwood Rd, Suite 103, North Little Rock, AR 72116-6864 | 2008-07-10 |
| 1538321260 | Crestwood Foot Clinic LLC | Prosthetic/Orthotic Supplier | 2501 Crestwood Rd, Suite 101, North Little Rock, AR 72116 | 2008-06-25 |
| 1063673440 | Peder Jensen, Dmd, Pa | Dentist | 2501 Crestwood Rd, Ste 102, North Little Rock, AR 72116-6864 | 2008-06-19 |
| 1962677906 | Crestwood Foot Clinic, LLC | Podiatrist | 2501 Crestwood Rd, Suite 101, North Little Rock, AR 72116-6864 | 2008-04-29 |
| 1093849770 | William F. Alfonso | Dentist | 2501 Crestwood Rd, Ste. 302, North Little Rock, AR 72116-6864 | 2007-03-15 |
| 1255497368 | Michael L. Quick, D.d.s., Pa | Dentist | 2501 Crestwood Rd, Suite 303, North Little Rock, AR 72116-6864 | 2007-01-01 |
| 1578631453 | John Howell Jr. | Dentist | 2501 Crestwood Rd, Suite 203, North Little Rock, AR 72116-7616 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710509997 | Dickerson Family Resource Center, LLC | Counselor | 5401 John F. Kennedy Blvd, Suite I Rm 1, North Little Rock, AR 72116 | 2020-05-11 |
| 1831609262 | Bill J Carpenter Sr. | Counselor | 4700 W Commercial Dr Ste B3, North Little Rock, AR 72116 | 2017-10-12 |
| 1992257646 | Meagan Booe | Behavioral Analyst | 3812 Lakewood Valley Drive, North Little Rock, AR 72116 | 2016-10-28 |
| 1295154300 | Min-ji Lee | Family Medicine | 2504 Mccain Blvd Ste 118, North Little Rock, AR 72116 | 2014-04-16 |
| 1255603486 | Crystal N Lackey | Physical Therapist | 3801 Jfk Blvd Ste C, North Little Rock, AR 72116 | 2012-02-03 |
| 1003055724 | North Little Rock, Pllc | Chiropractor | 4614 Jfk Blvd, North Little Rock, AR 72116 | 2009-02-19 |
| 1891933826 | Jennifer Ann Freilino | Counselor | 3805 Mccain Park Dr Ste 112, North Little Rock, AR 72116 | 2009-01-29 |
| 1679729669 | Amy Marie Jones | Speech-Language Pathologist | 5901 John F Kennedy Blvd Apt 5127, North Little Rock, AR 72116 | 2008-08-11 |
| 1992970917 | Ronald F Boyles Od Pa | Eyewear Supplier (Equipment, not the service) | 2520 Crestwood Road, North Little Rock, AR 72116 | 2008-04-30 |
| 1992976377 | Kencur Inc Statco Hearing Labs | Hearing Instrument Specialist | 4000 Mccain Blvd, Suite D, North Little Rock, AR 72116 | 2008-03-13 |
| Find all providers in zip 72116 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962677906 | Crestwood Foot Clinic, LLC | Podiatrist | 2501 Crestwood Rd, Suite 101, North Little Rock, AR 72116-6864 | 2008-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003210 | Healthy Connections Specialty, LLC | Podiatrist | 900 Martin Luther King Blvd Ste 108, Malvern, AR 72104-2217 | 2020-11-03 |
| 1417509597 | Dr. Austin Kramer P.a. | Podiatrist | 509 E Millsap Rd Ste Ve101, Fayetteville, AR 72703-4067 | 2019-07-10 |
| 1174092217 | Conway Regional Medical Center Inc. | Podiatrist | 550 Club Ln Ste 1, Conway, AR 72034-3681 | 2018-11-19 |
| 1457731804 | Tait Podiatry, LLC | Podiatrist | 2 Margeaux Ct, Little Rock, AR 72223-9193 | 2015-06-01 |
| 1386045763 | Rajnish Rammohan | Podiatrist | 5004 S U St Ste 101b, Fort Smith, AR 72903-3600 | 2014-09-04 |
| 1346651494 | Timothy Wayne Gauldin | Podiatrist | 106 Ridgeway St Ste D, Hot Springs, AR 71901-7157 | 2014-05-12 |
| 1902239486 | Austin Alan Kramer | Podiatrist | 509 E Millsap Rd Ste 101, Fayetteville, AR 72703-4862 | 2013-08-19 |
| 1609123223 | Supply and General Equipment, Inc. | Podiatrist | 13310 Kanis Road, Little Rock, AR 72211-4008 | 2012-08-14 |
| 1093949448 | Gina Marie Morgan | Podiatrist | 2308 Royal Ct Unit A, Bryant, AR 72022-4216 | 2009-05-13 |
| 1669635280 | Family Foot Clinic | Podiatrist | 203 Sevier St, Clarksville, AR 72830 | 2008-07-03 |
| Find all providers with the same taxonomy | ||||
| City | NORTH LITTLE ROCK |
| Zip Code | 72116 |
Please comment or provide details below to improve the information on DR. MARTHA A 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.