KENDRA JACKSON (NPI# 1114541455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114541455 |
| Entity Type | Individual |
| Full Name | KENDRA JACKSON |
| Credential | NP |
| Practice Address |
2809 Coltsgate Rd Ste 100 Charlotte NC 28211-5583 |
| Mailing Address |
326 Mill Creek Rd Iron Station NC 28080-5713 |
| Practice Telephone | 7047339202 |
| Mailing Telephone | 7048137348 |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2020-06-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5012135 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649520461 | Kendra Jackson | Behavioral Analyst | 730 Dorset Cir, Reno, NV 89506-1972 | 2012-09-19 |
| 1306126867 | Kendra Lorraine Jackson | Counselor | 2525 Riva Rd Ste 142, Annapolis, MD 21401-7411 | 2011-08-27 |
| 1548583164 | Kendra D Jackson | Behavioral Analyst | 8136 James Ct Apt A, Oklahoma City, OK 73145-4446 | 2010-03-10 |
| 1578726204 | Kendra Y Jackson | Licensed Vocational Nurse | 568 S Winery Ave, #104, Fresno, CA 93727-8239 | 2008-07-02 |
| 1649776469 | Kendra Joy Jackson | Pediatrics | 1000 Blythe Blvd Fl 4, Charlotte, NC 28203-5812 | 2018-04-02 |
| 1801297056 | Kendra Jackson | Counselor | 90 Hospital Dr, Athens, OH 45701-2301 | 2014-09-08 |
| Street Address |
2809 COLTSGATE RD STE 100 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28211-5583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184277832 | I and J Wheelchair Transportation | Non-emergency Medical Transport (VAN) | 1512 Delane Avenue, Charlotte, NC 28211 | 2019-07-22 |
| 1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
| 1649798273 | Ally Home Care Charlotte LLC | In Home Supportive Care | 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 | 2017-09-04 |
| 1154866770 | Vaibhav Bajaj | Dentist | 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 | 2017-01-05 |
| 1508254939 | Lindsay Marie Smits | Speech-Language Pathologist | 427 N. Wendover Rd., Charlotte, NC 28211 | 2015-01-08 |
| 1457755480 | Kristen Hammer | Physical Therapy Assistant | 4120 Providence Rd Apt D, Charlotte, NC 28211 | 2014-10-20 |
| 1669805610 | Carla Elizabeth Scott | Physical Therapist | 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 | 2013-08-14 |
| 1760726368 | Jill Hensdale Shipp | Social Worker | 307 Hunter Lane, Charlotte, NC 28211 | 2012-11-20 |
| 1346592722 | Danielle Marie Benoit | Occupational Therapist | 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 | 2012-10-09 |
| 1487910832 | John Joseph Marcel Jr. | Orthopaedic Surgery | 449 North Wendover Rd Ste A, Charlotte, NC 28211 | 2012-04-10 |
| Find all providers in zip 28211 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900268 | Jennifer Marie Wolfe | Nurse Practitioner | 831 E Morehead St Ste 900, Charlotte, NC 28202-2726 | 2020-10-19 |
| 1992312433 | Jean L. Caroline Clippard | Nurse Practitioner | 7149 Wessynton Dr, Charlotte, NC 28226-7548 | 2020-09-29 |
| 1790393676 | Alana Weldon | Nurse Practitioner | 10042 Park Cedar Dr, Charlotte, NC 28210-8916 | 2020-07-16 |
| 1740809599 | Nina Cherry Arnold | Nurse Practitioner | 8914 Cotton Press Rd, Charlotte, NC 28277-6676 | 2020-04-13 |
| 1619509197 | Clinica San Antonio Pllc | Nurse Practitioner | 416 Mccullough Dr Ste 110, Charlotte, NC 28262-4387 | 2020-02-12 |
| 1720626773 | Grace Barrosa Genetiano | Nurse Practitioner | 2503 Roswell Ave Unit 507, Charlotte, NC 28209-1685 | 2019-12-19 |
| 1376181081 | Crystal Delgado Calayag Frantilla | Nurse Practitioner | 4206 Craig Ave, Charlotte, NC 28211-3110 | 2019-12-12 |
| 1962059428 | Jerome Virgil Whitlow II | Nurse Practitioner | 6523 Dillard Ridge Dr, Charlotte, NC 28216-8845 | 2019-08-20 |
| 1053978213 | Katie Lynn Sass | Nurse Practitioner | 7004 Smith Corners Blvd Ste A, Charlotte, NC 28269-3827 | 2019-05-23 |
| 1710440722 | Andrea Denise Duncan | Nurse Practitioner | 2944 Hosta Dr, Charlotte, NC 28269-3054 | 2019-04-08 |
| Find all providers in CHARLOTTE | ||||
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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.