MICHAELA L JACKSON (NPI# 1154873057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154873057 |
| Entity Type | Individual |
| Full Name | MICHAELA L JACKSON |
| Credential | A.T.C |
| Practice Address |
105 Ashland Ave Clinton SC 29325-2960 |
| Mailing Address |
3201 Woodhaven Ct Sw Conyers GA 30094-3951 |
| Practice Telephone | 8648337098 |
| Mailing Telephone | 7703757665 |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
105 ASHLAND AVE |
| City | CLINTON |
| State | SC |
| Zip Code | 29325-2960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326455734 | Christine Hess | Specialist/Technologist | 105 Ashland Ave, Clinton, SC 29325-2960 | 2014-07-17 |
| 1437794278 | Danielle Rebecca Heidt | Specialist/Technologist | 105 Ashland Ave, Clinton, SC 29325-2960 | 2019-11-15 |
| 1063921146 | Kristen Marie Dodge | Specialist/Technologist | 105 Ashland Ave, Clinton, SC 29325-2960 | 2017-09-21 |
| 1669839742 | Tara Shelley | Specialist/Technologist | 105 Ashland Ave, Clinton, SC 29325-2960 | 2016-01-21 |
| 1427432657 | Nelson Jones | Specialist/Technologist | 105 Ashland Ave, Clinton, SC 29325-2960 | 2015-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353100 | Mason Paige Gambrell | Student in an Organized Health Care Education/Training Program | 107 Shellcreek Ct, Clinton, SC 29325 | 2020-07-07 |
| 1386207975 | Tammy Binger | Registered Nurse | 22725 U.S. 76, Clinton, SC 29325 | 2019-04-18 |
| 1154828945 | Lillian Smith | Physical Therapy Assistant | Nhc Clinton, 304 Jacobs Highway, Clinton, SC 29325 | 2018-04-09 |
| 1134519366 | Nora Pace | Specialist/Technologist | 18132 Hwy 72 E, Clinton, SC 29325 | 2015-01-26 |
| 1497186845 | John M. Griz | Orthopaedic Surgery | 22971 Hwy 76e, Clinton, SC 29325 | 2013-12-11 |
| 1992131171 | Sharon Kay Stoia | Occupational Therapist | 600 Plaza Circle, Clinton, SC 29325 | 2013-09-19 |
| 1578800256 | Hayes Ambulance Service LLC | Ambulance | 2143 Torrington Road, Clinton, SC 29325 | 2013-01-14 |
| 1083943518 | Margaret Estelle Shreve | Chiropractor | 209 Musgrove St, Clinton, SC 29325 | 2009-12-11 |
| 1750556213 | Piedmont Regional Urology | Urology | 300 Plantation Plaza, Suite F, Clinton, SC 29325 | 2008-04-25 |
| 1285821587 | Assisted Living Concepts Inc | Assisted Living Facility | 939 Springdale Drive, Clinton, SC 29325 | 2007-10-01 |
| Find all providers in zip 29325 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353100 | Mason Paige Gambrell | Student in an Organized Health Care Education/Training Program | 107 Shellcreek Ct, Clinton, SC 29325 | 2020-07-07 |
| 1467080960 | Jordan Elias Hobaica | Student in an Organized Health Care Education/Training Program | 3956 Cleary Rd, Clinton, NY 13323-4112 | 2020-03-30 |
| 1023464476 | Gregory Scott Medved | Student in an Organized Health Care Education/Training Program | 1874 N 1225 W, Clinton, UT 84015-8912 | 2016-05-04 |
| 1801109251 | Mary Lee | Student in an Organized Health Care Education/Training Program | 1150 State Route 54 W, Clinton, IL 61727-2148 | 2010-07-14 |
| 1144437237 | South Vermillion Community School Corporation | Student in an Organized Health Care Education/Training Program | 800 W. Wildcat Dr., Clinton, IN 47842-0387 | 2007-05-17 |
| 1902900996 | Paul Alan Fuentes | Student in an Organized Health Care Education/Training Program | 517 S 6th St, Clinton, OK 73601-4613 | 2006-09-11 |
| 1588277446 | Tori Weaver | Student in an Organized Health Care Education/Training Program | 19 Robinson Rd, Clinton, NY 13323-1418 | 2020-08-28 |
| 1114545043 | Benjamin Russell Hobaica | Student in an Organized Health Care Education/Training Program | 3956 Cleary Rd, Clinton, NY 13323-4112 | 2020-07-07 |
| 1679192082 | Henry Nathaniel Curry | Student in an Organized Health Care Education/Training Program | 607 Beaman St, Clinton, NC 28328-2603 | 2020-04-15 |
| 1073132338 | Yasmin Hadian | Student in an Organized Health Care Education/Training Program | 607 Beaman St, Clinton, NC 28328-2603 | 2020-04-15 |
| Find all providers in CLINTON | ||||
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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.