MR. THOMAS MICHAEL JACKSON (NPI# 1134380694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134380694 |
| Entity Type | Individual |
| Full Name | MR. THOMAS MICHAEL JACKSON |
| Credential | DO |
| Practice Address |
7 Bitterroot Road Carmen ID 83462 |
| Mailing Address |
7 Bitterroot Road Po Box 47 Carmen ID 83462 |
| Practice Telephone | 2087568047 |
| Mailing Telephone | 2087568047 |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 021 | ID | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811463334 | Thomas Spencer Jackson | Dentist | 1507 E Lamar Alexander Pkwy, Maryville, TN 37804-5131 | 2018-10-23 |
| 1255698759 | Thomas Jackson | Social Worker | 5240 Creed Dr, Summerfield, NC 27358-8284 | 2012-04-20 |
| 1851628549 | Thomas W Jackson | Dentist | 8160 Perry Hwy, Pittsburgh, PA 15237-5214 | 2009-11-17 |
| 1528181666 | Thomas Burton Jackson | Psychiatry & Neurology | 41750 Rancho Las Palmas Dr Ste D2, Rancho Mirage, CA 92270-5512 | 2007-04-06 |
| 1992827398 | Thomas Jackson | Social Worker | 228 Maple St, Middlebury, VT 05753-1606 | 2007-04-04 |
| 1528117306 | Thomas Boyd Jackson | Social Worker | 5225 Baysdon Cir, Jackson Consultant Services, LLC, Indianapolis, IN 46235-6040 | 2007-01-09 |
| 1245330950 | Thomas E Jackson | Internal Medicine | 47 Maple St #205, Summit, NJ 07901 | 2006-09-23 |
| 1679590137 | Thomas W Jackson | Psychiatry & Neurology | 3010 Beard Rd., Napa, CA 94558 | 2006-07-17 |
| 1306818968 | Thomas Cozatt Jackson Jr. | Family Medicine | 470 Linden Ave, Harrodsburg, KY 40330-1871 | 2006-02-07 |
| 1154308997 | Thomas L Jackson | Specialist | 2450 N Park Dr, Columbus, IN 47203-2216 | 2005-12-22 |
| Street Address |
7 BITTERROOT ROAD |
| City | CARMEN |
| State | ID |
| Zip Code | 83462 |
| 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 |
|---|---|---|---|---|
| 1780104851 | Cep America, LLC | Emergency Medicine | 4300 E. Flamingo Ave, Nampa, ID 83687-9203 | 2017-06-21 |
| 1740719905 | Courtney Hutchins | Emergency Medicine | 5841 S. Maryland Avenue Mc1052, J-141, Chicago, ID 60637 | 2017-06-09 |
| 1548798879 | Ideal Option, Pllc | Emergency Medicine | 3110 Cleveland Blvd Bldg A, Caldwell, ID 83605-0718 | 2017-05-31 |
| 1720468101 | Devin Douglas Dredge | Emergency Medicine | 1717 Arlington Ave Dept Of, Caldwell, ID 83605 | 2015-06-01 |
| 1972914406 | Jonathan Robert Jerkins | Emergency Medicine | 700 W Ironwood Dr Ste 155, Coeur D Alene, ID 83814-4462 | 2014-05-19 |
| 1457619074 | William P. Martin | Emergency Medicine | 1279 E Regatta St, Boise, ID 83706-6349 | 2012-05-02 |
| 1922365436 | Colby Austin | Emergency Medicine | 2963 E Copper Point Dr Ste 150, Meridian, ID 83642-9056 | 2012-04-20 |
| 1245514454 | Todd Robert Smith | Emergency Medicine | 3835 S Firenze Way, Meridian, ID 83642-1434 | 2011-10-06 |
| 1124306295 | Austin Heath Rasmussen | Emergency Medicine | 637 Pine St, Gooding, ID 83330-1755 | 2011-07-23 |
| 1962799460 | Tyler James Harris | Emergency Medicine | 1510 12th Ave Rd Ste 100, Nampa, ID 83686 | 2011-07-05 |
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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.