DR. SAM JACKSON (NPI# 1083812366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083812366 |
| Entity Type | Individual |
| Full Name | DR. SAM JACKSON |
| Credential | M.D. |
| Practice Address |
925 E Mcdowell Rd Floor 2 Phoenix AZ 85006-2502 |
| Practice Telephone | 6022392280 |
| Practice Fax Number | 6022394138 |
| Mailing Telephone | 6022392280 |
| Mailing Fax Number | 6022394138 |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207P00000X | Emergency Medicine | 35554 | AZ | Allopathic & Osteopathic Physicians |
| X | 207PT0002X |
Emergency Medicine Specialization: Medical Toxicology |
77351 | AZ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851750061 | Sam Jackson | Counselor | 4250 E Florian Ave, Building #1, Mesa, AZ 85206-2797 | 2016-02-16 |
| Street Address |
925 E MCDOWELL RD FLOOR 2 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85006-2502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386649564 | Michael John Conway | Surgery | 925 E Mcdowell Rd, Phoenix, AZ 85006 | 2005-06-15 |
| 1992220719 | Samantha Kathryn Sorg | Physician Assistant | 925 E Mcdowell Rd, Phoenix, AZ 85006 | 2017-08-14 |
| 1114378841 | Phillip Standen | Surgery | 925 E Mcdowell Rd, Phoenix, AZ 85006-2502 | 2016-06-23 |
| 1003266677 | Lacey Wood | Surgery | 925 E Mcdowell Rd, Department of Surgery, Phoenix, AZ 85006-2502 | 2016-06-15 |
| 1821448499 | Kelsey Hoidal | Surgery | 925 E Mcdowell Rd, Department of Surgery, Phoenix, AZ 85006-2502 | 2016-06-15 |
| 1003266701 | Angela Arreola | Surgery | 925 E Mcdowell Rd, Phoenix, AZ 85006-2502 | 2016-06-14 |
| 1326498965 | Robert Maher | Surgery | 925 E Mcdowell Rd, Department of Surgery, Phoenix, AZ 85006-2502 | 2016-06-14 |
| 1518317213 | Jena Bunda | Surgery | 925 E Mcdowell Rd, Phoenix, AZ 85006-2502 | 2016-06-14 |
| 1932559572 | Morgan Crigger | Surgery | 925 E Mcdowell Rd, Department of Surgery, Phoenix, AZ 85006-2502 | 2016-06-14 |
| 1316397003 | Caitlin Thornley | Surgery | 925 E Mcdowell Rd, Phoenix, AZ 85006-2502 | 2016-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356949929 | Teresa Louise Cox | Pharmacist | 1800 E Van Buren St., St. Luke's Behavioral Health, Phoenix, AZ 85006 | 2020-10-15 |
| 1558985036 | Amanda Stanford | Nurse Practitioner | 925 E Mc Dowell Rd, Phoenix, AZ 85006 | 2020-06-01 |
| 1023638582 | Supraja Prakash | Genetic Counselor, MS | 1920 E Cambridge Ave., Rosenberg Bldg., Suite 304, Phoenix, AZ 85006 | 2020-04-24 |
| 1760017099 | Phoenix Medical Psychiatric Hospital, LLC | Psychiatric Hospital | 1346 Mcdowell Road, Phoenix, AZ 85006 | 2020-03-06 |
| 1265093108 | Zulianna Ibrahim | Student in an Organized Health Care Education/Training Program | Banner University Medical Center Phoenix Family Medicin, 1300 N. 12th Street Suite 605, Phoenix, AZ 85006 | 2019-06-21 |
| 1306318340 | Leah Margaret Hillier | Family Medicine | 1300 N 12th St - Suite 500, Phoenix, AZ 85006 | 2018-12-31 |
| 1477032357 | Joann Moskop | Chiropractor | 2719 N Greenfield Rd., Phoenix, AZ 85006 | 2018-08-10 |
| 1619464468 | Ana Maria Lara | Naturopath | 926 E Mcdowell Rd Ste 204, Phoenix, AZ 85006 | 2018-04-17 |
| 1194221770 | Nisha Bharat Patel | Student in an Organized Health Care Education/Training Program | Edwards Medical Plaza Suite 320, 1300 North 12th Street, Phoenix, AZ 85006 | 2018-04-03 |
| 1710486352 | Julia Cyr | Registered Nurse | 1008 E Mcdowell Rd Unit A, Phoenix, AZ 85006 | 2018-02-09 |
| Find all providers in zip 85006 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627815 | Fep Ncch | Emergency Medicine | 8825 N 23rd Ave Ste 100, Phoenix, AZ 85021-4148 | 2020-10-22 |
| 1669861423 | Arthur Barker | Emergency Medicine | 4205 W Reddie Loop, Phoenix, AZ 85083-1610 | 2015-01-16 |
| 1326481102 | Adrienne R Azurdia | Emergency Medicine | 4237 E Liberty Ln, Phoenix, AZ 85048-0537 | 2013-04-11 |
| 1538401930 | Hannah Malashock | Emergency Medicine | 129 W Coronado Rd, Phoenix, AZ 85003-1144 | 2013-03-23 |
| 1982977922 | Robert Ellis George | Emergency Medicine | 1011 W. Golden Ln., Phoenix, AZ 85021 | 2012-02-22 |
| 1588972889 | Glenn Richard Kunsman | Emergency Medicine | 3507 N Central Ave Ste 403, Phoenix, AZ 85012-2124 | 2010-09-21 |
| 1073849501 | Melissa Denny | Emergency Medicine | 4225 E Mcdowell Rd Apt 1039, Phoenix, AZ 85008-4418 | 2009-10-17 |
| 1700111689 | Rachel Levitan | Emergency Medicine | 2601 E. Roosevelt, Department of Emergency Medicine, Phoenix, AZ 85008 | 2009-10-09 |
| 1891029328 | Patrick Godwin | Emergency Medicine | 5045 E Oneida St, Phoenix, AZ 85044-3325 | 2009-09-30 |
| 1689802209 | Robert John Mintz | Emergency Medicine | 9225 N 3rd St Ste 307, Phoenix, AZ 85020-2466 | 2009-06-23 |
| Find all providers in PHOENIX | ||||
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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.