GREGORY DWAIN JACKSON (NPI# 1104889070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104889070 |
| Entity Type | Individual |
| Full Name | GREGORY DWAIN JACKSON |
| Credential | M.D. |
| Practice Address |
2010 Brookwood Medical Ctr Dr Birmingham AL 35209-6804 |
| Mailing Address |
2090 Columbiana Rd Suite 4400 Birmingham AL 35216-2153 |
| Practice Telephone | 2058771990 |
| Practice Fax Number | 2058248111 |
| Mailing Telephone | 2058248000 |
| Mailing Fax Number | 2058248111 |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2007-11-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
11549 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BLUE CROSS/BLUE SHIELD | 51017074 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295194124 | Gregory L Jackson | Social Worker | 342 W Progress Rd, Prentiss, MS 39474-5221 | 2016-02-20 |
| 1811170293 | Gregory Emory Jackson | Pharmacist | 526 W 30th Street, Ny, NY 10001 | 2007-12-09 |
| 1801970769 | Gregory Wayne Jackson | Dentist | 6435 S Pulaski Rd, Chicago, IL 60629-5148 | 2006-10-25 |
| 1184738825 | Gregory Mann Jackson | Specialist | 4220 Mccullough Ave, San Antonio, TX 78212-1910 | 2006-08-19 |
| 1134158009 | Gregory Alan Jackson | Physical Therapist | 5501 Swift Rd, Sarasota, FL 34231-6209 | 2006-07-02 |
| 1982640090 | Gregory R Jackson | Radiology | 800 Mercy Hospital, Alegent Mercy Hospital, Council Bluffs, IA 51503 | 2006-06-20 |
| 1356306203 | Gregory Lee Jackson | Specialist/Technologist | 3821 Everetts Dl, Lexington, KY 40514-1185 | 2006-04-20 |
| 1568092088 | Gregory Christopher Jackson | Psychologist | 4141 Geary Blvd, San Francisco, CA 94118-3109 | 2020-01-23 |
| 1346747110 | Gregory Jackson | Student in an Organized Health Care Education/Training Program | 1161 21st Ave S, Nashville, TN 37232-0004 | 2018-04-09 |
| 1285167304 | Gregory M. Jackson II | Nurse Practitioner | 8600 Wurzbach Rd, Suite 1110, San Antonio, TX 78240-4330 | 2017-04-05 |
| Street Address |
2010 BROOKWOOD MEDICAL CTR DR |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35209-6804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194720631 | Jasper L. Booker | Anesthesiology | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2005-06-20 |
| 1992322242 | Sarah Swindle | Social Worker | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2020-07-02 |
| 1841810447 | Nicole A Thomas | Registered Nurse | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2020-04-23 |
| 1487274510 | Cecily Metzler | Registered Nurse | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2020-04-18 |
| 1710516372 | Kyrie Nicole Carlson | Registered Nurse | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2020-04-06 |
| 1164050027 | Anna Maria Francesca Ceravolo | Registered Nurse | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2020-03-27 |
| 1174156467 | Jennifer Nicole Jebeles | Nurse Practitioner | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2020-02-15 |
| 1528604709 | Shelby Alexandria Colburn | Registered Nurse | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2019-11-21 |
| 1225673445 | Melinda Louise Gunter | Registered Nurse | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2019-11-12 |
| 1972145373 | Stacey Bessiere | Registered Nurse | 2010 Brookwood Medical Ctr Dr, Birmingham, AL 35209-6804 | 2019-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437793510 | Marissa M Mcintyre | Registered Nurse | 3401 Independence Drive, Suite 221, Birmingham, AL 35209 | 2019-11-01 |
| 1093284457 | Patriot Healthcare of Alabama, LLC | Family Medicine | 2045 Brookwood Medical Center Drive, Suite 1, Birmingham, AL 35209 | 2018-11-15 |
| 1164902268 | Lucy Johnston | Physician Assistant | 1602 Woodfern Dr, Homewood, AL 35209 | 2018-08-17 |
| 1881184646 | Wade Louis Grady | Specialist/Technologist | 800 Larkshore Drive, Birmingham, AL 35209 | 2018-05-16 |
| 1154823029 | Taylor Payne | Physical Medicine & Rehabilitation | 109 Devon Dr, Birmingham, AL 35209 | 2018-03-06 |
| 1396251542 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 120 Oxmoor Blvd Ste 100, Birmingham, AL 35209 | 2017-12-26 |
| 1376060954 | Hannah Holloway | Specialist/Technologist | 725 Crest Lane, Birmingham, AL 35209 | 2017-08-24 |
| 1558887463 | Paul A Rhodes | Nurse Practitioner | 631 Beacon Center Office Park, Suite 108, Birmingham, AL 35209 | 2017-08-22 |
| 1538542196 | Proteus Molecular and Clinical Lab LLC | Clinical Medical Laboratory | 218 Summit Pkwy, Suite 250, Homewood, AL 35209 | 2015-07-01 |
| 1124407739 | Randall Alban | Nurse Practitioner | 2100 Southbridge Parkway, Suite 650, Birmingham, AL 35209 | 2015-05-28 |
| Find all providers in zip 35209 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497241756 | Anurag Chahal | Radiology | Department of Radiology 619 19th Street South, Birmingham, AL 35249-0001 | 2018-07-10 |
| 1346782307 | Birmingham Physicians Radiology Pllc | Radiology | 3425 Colonnade Pkwy, Birmingham, AL 35243-2356 | 2016-11-08 |
| 1194111245 | Darrel Alexander Ceballos | Radiology | 619 19th Street South Jt N382, Birmingham, AL 35294-2238 | 2015-04-15 |
| 1356754956 | Brandon Phillips | Radiology | 619 19th St S Dept Of, Birmingham, AL 35233-1900 | 2014-06-11 |
| 1306258751 | Benjamin Ross Snead | Radiology | 3690 Grandview Pkwy Dept Of, Birmingham, AL 35243-3326 | 2014-05-20 |
| 1538586433 | David Breland | Radiology | 2204 Lakeshore Dr Ste 140, Birmingham, AL 35209-6741 | 2014-03-28 |
| 1649603267 | Dane David Hellwig | Radiology | 1211 Concord Ave, Birmingham, AL 35213-2120 | 2013-08-19 |
| 1982982047 | Bradley James Cherenzia | Radiology | 655 Chester St, Birmingham, MI 48009-1436 | 2011-07-23 |
| 1891088670 | George R Newman | Radiology | 341 Kingston Cir, Birmingham, AL 35211-6982 | 2011-05-26 |
| 1518250067 | Chandler Hargrove Smith | Radiology | 368 Vesclub Drive, Birmingham, AL 35216 | 2011-05-17 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35209 |
Please comment or provide details below to improve the information on GREGORY DWAIN 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.