MR. CHRISTOPHER M JACKSON (NPI# 1093285496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093285496 |
| Entity Type | Individual |
| Full Name | MR. CHRISTOPHER M JACKSON |
| Credential | FNP-BC |
| Practice Address |
302 Kensington Ave Flint MI 48503-2044 |
| Mailing Address |
204 Pine St Corunna MI 48817-1031 |
| Practice Telephone | 8107628400 |
| Mailing Telephone | 8104490566 |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2019-04-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704247130 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 204 Pine St, Corunna, MI 488171031 | 8104490566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417502998 | Christopher Robert Jackson | Residential Treatment Facility, Emotionally Disturbed Children | 1502 Liatris Ln, North Pole, AK 99705-5082 | 2019-08-01 |
| 1144880469 | Christopher Luke Jackson | Registered Nurse | 2177 N Brower St, Simi Valley, CA 93065-2447 | 2019-06-18 |
| 1427612480 | Christopher John Jackson | Registered Nurse | 8921 Harvey St, Livonia, MI 48150-3518 | 2019-04-25 |
| 1972009041 | Christopher Carl Jackson | Physical Therapist | 1230 Felice Cutoff Rd, Ragley, LA 70657-6645 | 2018-04-05 |
| 1538674312 | Christopher D. Jackson | Counselor | 165 Warner St, Rochester, NY 14606-1832 | 2017-12-03 |
| 1720513997 | Christopher Ainsley Nally Jackson | Massage Therapist | 124 Wren Way, Newark, DE 19711-8330 | 2017-04-25 |
| 1073980736 | Christopher G Jackson | Physical Therapist | 3143 Pelham Pkwy Ste 400, Pelham, AL 35124-6301 | 2015-08-28 |
| 1932442498 | Christopher Paul Jackson | Technician | 7821 Island Dr, Anchorage, AK 99504-2728 | 2013-04-03 |
| 1710229224 | Christopher Mitchell Jackson | Neurological Surgery | 600 N Wolfe St Tower 110, The Johns Hopkins Hospital, Baltimore, MD 21287-2109 | 2013-03-22 |
| 1417107947 | Christopher L Jackson | Acupuncturist | 7901 4th St N Ste 312, St Petersburg, FL 33702 | 2008-09-20 |
| Street Address |
302 KENSINGTON AVE |
| City | FLINT |
| State | MI |
| Zip Code | 48503-2044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891782736 | James Ewell Graham Jr. | Obstetrics & Gynecology | 302 Kensington Ave, Genesys Hurley Cancer Institute, Flint, MI 48503-2044 | 2005-10-05 |
| 1831797638 | Kristin Dunaway | Nurse Practitioner | 302 Kensington Ave, Flint, MI 48503-2044 | 2020-10-14 |
| 1992246904 | Larsen Medical Plc | Surgery | 302 Kensington Ave, Flint, MI 48503-2044 | 2017-03-10 |
| 1467801985 | Collaborative Radiation Oncology Pllc | Radiology | 302 Kensington Ave, Flint, MI 48503-2044 | 2016-06-06 |
| 1942612577 | Amy Jiries Calati | Internal Medicine | 302 Kensington Ave, Flint, MI 48503-2044 | 2014-06-02 |
| 1104161363 | Dong Whan Oh Md Pllc | Radiology | 302 Kensington Ave, Flint, MI 48503-2044 | 2012-11-29 |
| 1124362272 | Haesook S Kim Md Pllc | Radiology | 302 Kensington Ave, Flint, MI 48503-2044 | 2012-11-15 |
| 1962795013 | Sirisha Manyam | Internal Medicine | 302 Kensington Ave, Flint, MI 48503-2044 | 2011-05-24 |
| 1588971261 | Anne Marie Cox | Dietitian, Registered | 302 Kensington Ave, Flint, MI 48503-2044 | 2010-09-02 |
| 1356572135 | Douglas M Iddings PC | Surgery | 302 Kensington Ave, Flint, MI 48503-2044 | 2009-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457971640 | Flint Odyssey House Inc. | Community/Behavioral Health | 1219 Martin Luther King Avenue, Flint, MI 48503 | 2020-04-17 |
| 1891265476 | Mary Margaret Woodruff | Health Educator | 411 E. Third St Suite 2, Flint, MI 48503 | 2018-11-27 |
| 1669942223 | Donna Jean Phelps | Behavior Technician | 2284 S Ballenger Highway, Flint, MI 48503 | 2018-11-27 |
| 1588150601 | Dayonna Scott | Social Worker | Hope Network, 2830 Corunna Rd, Flint, MI 48503 | 2018-07-02 |
| 1801388020 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2284 S Ballenger Hwy Ste F, Flint, MI 48503 | 2018-06-04 |
| 1134610504 | Swathi Gorle | Student in an Organized Health Care Education/Training Program | Hurley Medical Center, 1 Hurley Plaza, Flint, MI 48503 | 2018-05-22 |
| 1881128049 | Kara Garr | Registered Nurse | 805 Tuuri Pl, Flint, MI 48503 | 2017-04-14 |
| 1518405638 | Thomasinia Terrell | Peer Specialist | 422 W Fourth Ave, Flint, MI 48503 | 2017-02-09 |
| 1790231041 | Roslyn Boyce | Technician, Other | 2213 E. Court Street, Flint, MI 48503 | 2016-08-28 |
| 1689120818 | Yasmine Elhefnawy | Student in an Organized Health Care Education/Training Program | One Hurley Plaza 3d West, Flint, MI 48503 | 2016-08-28 |
| Find all providers in zip 48503 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831739523 | Tiffany M Stafford | Nurse Practitioner | 5536 S Saginaw Rd, Flint, MI 48507-4421 | 2020-01-09 |
| 1184269599 | Tamela Renae Callahan | Nurse Practitioner | 20188 Ridgerock Dr, Flint, TX 75762-9335 | 2019-11-08 |
| 1164982229 | Randi Lynn Ballard-dickerson | Nurse Practitioner | 1140 S Linden Rd Bldg A, Flint, MI 48532-3437 | 2019-03-23 |
| 1710454111 | Brian Mcdermott | Nurse Practitioner | 1230 S Linden Rd Ste 4, Flint, MI 48532-3424 | 2018-10-24 |
| 1861981292 | Lavonne L Alexander | Nurse Practitioner | 4500 S Saginaw St Ste 1875, Flint, MI 48507 | 2018-05-01 |
| 1144728593 | Matthew Thomas Evans | Nurse Practitioner | 1125 S Linden Rd Ste 900, Flint, MI 48532-4068 | 2018-01-30 |
| 1093213977 | Sandy Holland | Nurse Practitioner | 4100 Beecher Road, Flint, MI 48532-2819 | 2018-01-25 |
| 1245760883 | Melinda Sue Williams | Nurse Practitioner | 2304 Bradford Dr, Flint, MI 48507-4404 | 2017-06-15 |
| 1912340332 | Patricia Ann Ward | Nurse Practitioner | 1401 E. Court, Mott Community College Health Services, Flint, MI 48503 | 2013-04-16 |
| 1710119904 | Laura Lea Szakal | Nurse Practitioner | 1386 S Linden Rd, Flint, MI 48532-4185 | 2009-08-20 |
| Find all providers in FLINT | ||||
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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.