MR. SHAWN E JACKSON (NPI# 1053577825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053577825 |
| Entity Type | Individual |
| Full Name | MR. SHAWN E JACKSON |
| Credential | P.T. |
| Practice Address |
2701 Larsen Rd Suite 111 Green Bay WI 54303-4863 |
| Practice Telephone | 9208832284 |
| Practice Fax Number | 9208841026 |
| Mailing Telephone | 9208832284 |
| Mailing Fax Number | 9208841026 |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2015-05-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | #4899-024 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316393796 | Shawn Pierre Jackson | Counselor | 3242 S Lakewood Ave, 2f, Tulsa, OK 74135-4910 | 2016-05-04 |
| 1619305380 | Shawn Jackson | Counselor | 196 Sussex Dr, Monroe, LA 71203-3324 | 2013-10-16 |
| 1578027736 | Shawn Rene'e Jackson | Occupational Therapy Assistant | 201 E Thompson St, Decatur, TX 76234-2736 | 2019-01-22 |
| 1174054068 | Shawn Jackson | Pharmacist | 300 Pullman St Bldg G, Livermore, CA 94551-9756 | 2017-03-23 |
| 1528413911 | Shawn Jackson | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2016-05-04 |
| 1780078915 | Shawn Jackson | Anesthesiology | 300 Longwood Ave, Boston Childrens Hospital, Hunnewell Bldg, Pavilion 129, Boston, MA 02115-5724 | 2015-03-25 |
| 1225391352 | Shawn D. Jackson | Nurse Practitioner | 125 S 9th St, Philadelphia, PA 19107-5125 | 2012-06-22 |
| 1487922837 | Shawn A Jackson | Counselor | 10532 N. Port Washington Rd., Mequon, WI 53092 | 2011-12-13 |
| 1437441276 | Shawn D Jackson | Physical Therapist | 777 Bannock St, Denver, CO 80204-4507 | 2011-05-12 |
| 1841479342 | Shawn Nichole Jackson | Occupational Therapy Assistant | 1415 Route 70 E, Suite 103, Cherry Hill, NJ 08034-2210 | 2007-10-31 |
| Street Address |
2701 LARSEN RD SUITE 111 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-4863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942399449 | Risa Lynn Janowski | Counselor | 2701 Larsen Rd, Green Bay, WI 54303-4863 | 2006-10-12 |
| 1265863336 | Amber Gravitter | Counselor | 2701 Larsen Rd, Green Bay, WI 54303-4863 | 2013-11-27 |
| 1639410434 | Renew Physical Therapy, Inc | Clinic/Center | 2701 Larsen Rd, Suite 111, Green Bay, WI 54303-4863 | 2013-03-05 |
| 1417242256 | Promises Counseling Services, LLC | Community/Behavioral Health | 2701 Larsen Rd, Green Bay, WI 54303-4863 | 2011-06-09 |
| 1285800052 | Brown County Oral Health Partnership, Inc. | Public Health or Welfare | 2701 Larsen Rd, Green Bay, WI 54303-4863 | 2008-05-01 |
| 1720132806 | Harbor Community Psychological Associates Sc | Psychologist | 2701 Larsen Rd, Green Bay, WI 54303-4863 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356967558 | Theresa Ynez Baclohan Polistico | Physical Therapist | 2080 Verlin Rd Apt 16, Green Bay, WI 54311-6289 | 2020-06-23 |
| 1245716190 | John Kiskin | Physical Therapist | 403 N Ashland Ave, Green Bay, WI 54303-2803 | 2018-07-13 |
| 1689120941 | Sarah Lynn Anderson | Physical Therapist | 835 Webster, Green Bay, WI 54301-3526 | 2016-08-28 |
| 1164802567 | Bradley D Sarder | Physical Therapist | 2845 Greenbrier Rd Fl 2, Green Bay, WI 54311-6519 | 2015-06-02 |
| 1275943276 | Joshua Arvey | Physical Therapist | 615 Rolling Green Dr, Green Bay, WI 54313-5146 | 2014-04-30 |
| 1801192422 | Michael John Laviolette | Physical Therapist | 740 Aerostar Ln, Green Bay, WI 54313-6987 | 2011-01-28 |
| 1184873564 | Shawn G. Christenson | Physical Therapist | 600 S. Webster, Green Bay, WI 54301 | 2008-09-10 |
| 1003070707 | Anne Marie Hein | Physical Therapist | 3101 S Packerland Dr, Green Bay, WI 54313 | 2008-07-11 |
| 1669648119 | Renee Anderson | Physical Therapist | 3101 Packerland Dr, Green Bay, WI 54313-6187 | 2008-05-05 |
| 1093981623 | Jennifer Lynn Balthazor | Physical Therapist | 2919 Shelter Creek Ct, Green Bay, WI 54313-4549 | 2008-05-04 |
| Find all providers in GREEN BAY | ||||
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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.