DR. JILL DOUGAL MACKINNON


Address: 2001 Dwight Way, 2nd Floor - Room # 2350, Berkeley, CA 94704-2608
Phone: 5102044738

DR. JILL DOUGAL MACKINNON (NPI# 1134201627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134201627
Entity Type Individual
Full Name DR. JILL DOUGAL MACKINNON
Credential M.D.
Practice Address 2001 Dwight Way
2nd Floor - Room # 2350
Berkeley
CA 94704-2608
Practice Telephone 5102044738
Practice Fax Number 5102045892
Mailing Telephone 5102044738
Mailing Fax Number 5102045892
Enumeration Date 2006-10-20
Last Update Date 2007-07-09
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 204D00000X Neuromusculoskeletal Medicine & OMM G67976 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA MEDI-CAL 00G679760 01

Office Location

Street Address 2001 DWIGHT WAY
2ND FLOOR - ROOM # 2350
City BERKELEY
State CA
Zip Code 94704-2608

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295738805 Bay Area Rehabilitation Medical Group Physical Medicine & Rehabilitation 2001 Dwight Way, Berkeley, CA 94704-2608 2005-05-27
1366083545 Jamba Dolkar Tenzing Nurse Practitioner 2001 Dwight Way, Berkeley, CA 94704-2608 2019-09-30
1013401983 Lindsey Olander Speech-Language Pathologist 2001 Dwight Way, Berkeley, CA 94704-2608 2018-06-14
1447604814 Sutter Bay Hospitals Psychiatric Unit 2001 Dwight Way, Berkeley, CA 94704-2608 2016-04-21
1235583360 Mariam Kamyab Registered Nurse 2001 Dwight Way, Ste 1388, Berkeley, CA 94704-2608 2016-04-14
1336529106 Alta Bates Summit Medical Center Clinic/Center 2001 Dwight Way, Berkeley, CA 94704-2608 2015-06-05
1538563614 Sutter East Bay Hospitals Pharmacy 2001 Dwight Way, Suite 2182, Berkeley, CA 94704-2608 2014-10-17
1821405192 Altabates Comprehensive Cancer Center Clinic/Center 2001 Dwight Way, Berkeley, CA 94704-2608 2014-07-17
1942624408 Karri Kennedy Occupational Therapist 2001 Dwight Way, Berkeley, CA 94704-2608 2014-02-04
1740611375 Rebecca Hummel-moore Nurse Practitioner 2001 Dwight Way, Berkeley, CA 94704-2608 2013-12-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1821698887 Ka Yin Emma Liu Counselor 1936 University Avenue, Partnerships for Trauma Recover, Suite 191, Berkeley, CA 94704 2020-10-29
1821617168 Michelle Nagal Hunt Behavior Technician 2080 Addison Street, #302, Berkeley, CA 94704 2020-04-15
1366097081 Sabrina Barnett Behavior Technician 2080 Addison St, #302, Berkeley, CA 94704 2019-08-08
1811559735 Bonita House, Inc. Community/Behavioral Health 1909 University Ave, Berkeley, CA 94704 2019-07-01
1376014928 Justin T Cooke Specialist/Technologist 2024 Durant Ave #508, Berkeley, CA 94704 2018-12-07
1972080158 Cecilia Winfield Student in an Organized Health Care Education/Training Program 1918 University Ave., Suite 2b, Berkeley, CA 94704 2018-07-20
1952897332 Jennifer Henry Henry Naturopath 2041 Bancroft Way #303, 2041 Bancroft Way, Berkeley, CA 94704 2018-07-09
1497267967 Merlenet Michelle Riley Counselor 2640 Martin Luther King, Berkeley, CA 94704 2017-10-24
1265951719 Caitlin Mary Mcdonough Student in an Organized Health Care Education/Training Program 1918 University Avenue, Suite 2b, Berkeley, CA 94704 2017-09-15
1922525120 Patrice Werling Counselor 1918 University Avenue, Suite 2b, Berkeley, CA 94704 2017-08-28
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Taxonomy Information

Taxonomy Code 204D00000X
Grouping Allopathic & Osteopathic Physicians
Classification Neuromusculoskeletal Medicine & OMM

Taxonomy Definition

The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients.
Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition]
- Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144860743 Roeshan Shadravan Neuromusculoskeletal Medicine & OMM 1505 Lomas Santa Fe Dr, Solana Beach, CA 92075-2103 2020-01-11
1548722416 R. Mitchell Hiserote Do, Professional Corporation Neuromusculoskeletal Medicine & OMM 7064 Corline Ct Ste C1, Sebastopol, CA 95472-4528 2019-04-01
1851768899 Petaluma Acupuncture Center Neuromusculoskeletal Medicine & OMM 720 Southpoint Blvd Ste 211, Petaluma, CA 94954-7496 2015-08-25
1063800258 Kulveen Sachdeva, Md Inc. Neuromusculoskeletal Medicine & OMM 5401 Norris Canyon Road, Suite 110, San Ramon, CA 94583-5402 2014-12-23
1982010559 Walter Jaye Cohen Neuromusculoskeletal Medicine & OMM 3706 Ruffin Rd Ste 129, San Diego, CA 92123-1812 2014-07-03
1962815068 Sunil Bhat Neuromusculoskeletal Medicine & OMM 2555 Flores St Ste 395, San Mateo, CA 94403-2344 2014-06-05
1417298811 Sibyl Knight Neuromusculoskeletal Medicine & OMM 199 17th St Ste J, Pacific Grove, CA 93950 2013-03-09
1447597349 Lee Ann Marie Cuny Neuromusculoskeletal Medicine & OMM 1502 Tennessee St, Vallejo, CA 94590-4627 2013-01-11
1285985820 Annette Hulse Neuromusculoskeletal Medicine & OMM 1 1st St Ste 3, Los Altos, CA 94022-2753 2012-09-23
1871853796 Brian Peternell Neuromusculoskeletal Medicine & OMM 584 35th Ave, Santa Cruz, CA 95062-5111 2012-05-24
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Competitor

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City BERKELEY
Zip Code 94704

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Dataset Information

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.

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