CAROL ANN JACKSON-GIBSON (NPI# 1164421442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164421442 |
| Entity Type | Individual |
| Full Name | CAROL ANN JACKSON-GIBSON |
| Credential | MD |
| Practice Address |
1150 Youngs Rd Suite 111 Williamsville NY 14221-8053 |
| Practice Telephone | 7166887622 |
| Practice Fax Number | 7166887592 |
| Mailing Telephone | 7166887622 |
| Mailing Fax Number | 7166887592 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2013-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
176786 | NY | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
176786 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | UNIVERA/EXCELLUS # | 00025193901 | 01 |
| NY | 01598136 | 05 | |
| NY | BLUE CROSS WNY # | 000525515015 | 01 |
| NY | INDEPENDENT HEALTH # | 5609475 | 01 |
| NY | RAILROAD MEDICARE # | 300118785 | 01 |
| NY | PREFERRED CARE-ROCHESTER | 150589FF | 01 |
| NY | WORKERS COMPENSATION # | CR-DRA176786-2W | 01 |
| Street Address |
1150 YOUNGS RD SUITE 111 |
| City | WILLIAMSVILLE |
| State | NY |
| Zip Code | 14221-8053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780237578 | Meaghan Mary Piegay | Physician Assistant | 1150 Youngs Rd, Suite 104, Williamsville, NY 14221 | 2019-07-20 |
| 1457884470 | Highgate Medical Group | Physician Assistant | 1150 Youngs Rd, Suite 104, Williamsville, NY 14221-8053 | 2017-04-06 |
| 1770936874 | Kristen Elizabeth Rudroff | Physician Assistant | 1150 Youngs Rd, Williamsville, NY 14221-8053 | 2016-07-13 |
| 1194183897 | Diane Federowicz | Licensed Practical Nurse | 1150 Youngs Rd, Suite 104, Williamsville, NY 14221-8053 | 2016-02-09 |
| 1801254503 | Linda Smigiel | Licensed Practical Nurse | 1150 Youngs Rd, Suite 104, Williamsville, NY 14221-8053 | 2016-02-09 |
| 1790127298 | Jeila Kerdar | Physician Assistant | 1150 Youngs Rd, Suite 203, Williamsville, NY 14221-8053 | 2013-07-24 |
| 1396099867 | Jessica Jean Oppee | Audiologist | 1150 Youngs Rd, Suite 209, Williamsville, NY 14221-8053 | 2012-11-05 |
| 1104172287 | Emily E Mcgowan | Physician Assistant | 1150 Youngs Rd, Williamsville, NY 14221-8053 | 2012-07-26 |
| 1447547310 | Mandy Lynn Abram | Physician Assistant | 1150 Youngs Rd, Suite104, Williamsville, NY 14221-8053 | 2011-06-29 |
| 1881987683 | Michael Robert Dlugosz | Family Medicine | 1150 Youngs Rd, Suite 104, Williamsville, NY 14221-8053 | 2011-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447552 | Kuldesh Singh Ubhi | Student in an Organized Health Care Education/Training Program | 850 Hoplins Road, Williamsville, NY 14221 | 2020-11-04 |
| 1992304968 | Nicholas Robinson | Nurse Practitioner | 295 Essjay, Williamsville, NY 14221 | 2020-10-21 |
| 1457961104 | Maria Fagant | Licensed Practical Nurse | 2550 Wehrle Drive Suite 1, Williamsville, NY 14221 | 2020-08-07 |
| 1073136362 | Nicole Marie Mauro | Licensed Practical Nurse | 2550 Wehrle Drive, Williamsville, NY 14221 | 2020-05-21 |
| 1982258422 | Schenk Primary Care Medicine, Pllc | Clinic/Center | 2350 Maple Road Suite 100, Amherst, NY 14221 | 2019-08-01 |
| 1669031365 | Anh Thi Nguyet Phan | Student in an Organized Health Care Education/Training Program | 850 Hopkins Rd., Williamsville, NY 14221 | 2019-06-07 |
| 1801453394 | Buffalo Medical Group, PC | Clinic/Center | 325 Essjay, Williamsville, NY 14221 | 2019-05-21 |
| 1265097265 | Christine Marie Wolniewicz | Dietitian, Registered | 507 Maple Rd., Williamsville, NY 14221 | 2019-05-06 |
| 1750844957 | Myles S Faith | Psychologist | 190 Rollingwood Street, Williamsville, NY 14221 | 2019-04-13 |
| 1902376536 | Shane Michael Stadtmueller | Chiropractor | 5820 Main St. Suite 201, Williamsville, NY 14221 | 2018-11-27 |
| Find all providers in zip 14221 | ||||
| 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 |
|---|---|---|---|---|
| 1851601587 | Teleradiology of New York, PC | Radiology | 125 Galileo Drive, Williamsville, NY 14221 | 2010-10-15 |
| 1942526777 | Asha Diane Ziembiec | Radiology | 199 Park Club Ln Ste 300, Williamsville, NY 14221-5269 | 2010-04-19 |
| 1740392356 | Gerard Paul Florio | Radiology | 11 Carleton Ct, Williamsville, NY 14221-1749 | 2006-08-31 |
| 1649212366 | Amherst Imaging Solutions, Pllc | Radiology | 4140 Sheridan Dr, Williamsville, NY 14221-4341 | 2006-06-10 |
| 1689629396 | John Coscia | Radiology | 55 Lanoche Ct, Williamsville, NY 14221-1977 | 2006-05-23 |
| 1194784892 | Arooj Maqbool Shaikh | Radiology | 55 Spindrift Drive, Williamsville, NY 14221 | 2006-03-21 |
| 1710961149 | Gregory T Tymchak | Radiology | 100 College Pkwy, Suite 180, Williamsville, NY 14221-6800 | 2005-11-30 |
| 1003807132 | Proscan Radiology Buffalo, Pllc | Radiology | 5214 Main St, Williamsville, NY 14221-5373 | 2005-10-28 |
| 1457863904 | Christopher Nicholas | Radiology | 199 Park Club Ln Ste 300, Williamsville, NY 14221-5269 | 2017-10-24 |
| 1326453259 | Salah Abdelhadi | Radiology | 199 Park Club Ln Ste 300, Williamsville, NY 14221-5269 | 2014-06-30 |
| Find all providers in WILLIAMSVILLE | ||||
| City | WILLIAMSVILLE |
| Zip Code | 14221 |
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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.