DR. CLINTONIA JACKSON (NPI# 1164585790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164585790 |
| Entity Type | Individual |
| Full Name | DR. CLINTONIA JACKSON |
| Other Name | DR. CLINTONIA BOX |
| Credential | M.D. |
| Practice Address |
5 Memorial Medical Ct Greenville SC 29605-4449 |
| Mailing Address |
3620 Pelham Rd Pmb 145 Greenville SC 29615-5044 |
| Practice Telephone | 8642723409 |
| Mailing Telephone | 3216987637 |
| Mailing Fax Number | 3073160409 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2016-08-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | ME66277 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 000042300 | 05 |
| Street Address |
5 MEMORIAL MEDICAL CT |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427013382 | Greenville Surgery Center Limited Partnership | Clinic/Center | 5 Memorial Medical Ct, Greenville, SC 29605-4449 | 2006-04-20 |
| 1578722633 | Greenville Surgery Center Lp | Clinic/Center | 5 Memorial Medical Ct, Greenville, SC 29605-4449 | 2008-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396207221 | Prisma Health-upstate | Anesthesiology | 905 Verdae Blvd Ste 102, Greenville, SC 29607-4029 | 2019-04-01 |
| 1841796620 | Charles Edward Reier | Anesthesiology | 520 Wildrose Ln, Greenville, OH 45331-2472 | 2018-04-02 |
| 1871972836 | Chelsey Woodrum | Anesthesiology | 306 Treybrooke Cir, Apt 24, Greenville, NC 27834-5961 | 2015-05-23 |
| 1710316153 | Federico Pascual Vallesteros | Anesthesiology | 223 Greenville Rd, Greenville, PA 16125 | 2013-11-06 |
| 1619269859 | Jessica Shuffler Gonzalez | Anesthesiology | 67 Creekeside Park Court, Greenville, SC 29615-4810 | 2011-05-06 |
| 1750561197 | James Ross Simril | Anesthesiology | 1 St. Francis Drive, Greenville, SC 29601-3955 | 2007-11-13 |
| 1902094485 | Coastal Pain Medicine, LLC | Anesthesiology | 2905 Groveland Dr, Greenville, NC 27858-7188 | 2007-10-09 |
| 1093805152 | Kevin Burton Walker | Anesthesiology | 21 Brendan Way, Greenville, SC 29615-3514 | 2006-10-12 |
| 1083644181 | Asit Patel | Anesthesiology | 42 Oxford Way, Greenville, DE 19807-2569 | 2006-07-04 |
| 1508800079 | Alan Wayne Smith | Anesthesiology | 67 Creekside Drive, Greenville, SC 29615 | 2006-06-15 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
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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.