ALYSSA JACKSON (NPI# 1174053433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174053433 |
| Entity Type | Individual |
| Full Name | ALYSSA JACKSON |
| Credential | OD |
| Practice Address |
3929 Lamar Dr Clarksville TN 37040-3704 |
| Mailing Address |
3929 Lamar Dr Ste. B Clarksville TN 37040-1425 |
| Practice Telephone | 9312453979 |
| Practice Fax Number | 9316470354 |
| Mailing Telephone | 9312453937 |
| Mailing Fax Number | 9316470354 |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2020-02-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 3377 | TN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | LICENSE NUMBER | 3377 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266078 | Alyssa Jane Jackson | Nurse Practitioner | 1701 38th St S Ste 101, Fargo, ND 58103-4499 | 2020-08-17 |
| Street Address |
3929 LAMAR DR |
| City | CLARKSVILLE |
| State | TN |
| Zip Code | 37040-3704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770124380 | Clarksville Treatment Center, LLC | Clinic/Center | 495 Dunlop Lane, Clarksville, TN 37040 | 2019-10-04 |
| 1295384956 | Dena Marie Borchick | Technician | 3779 Cindy Jo Dr. N, Clarksville, TN 37040 | 2019-09-05 |
| 1477014488 | Emily Allen | Dentist | 930 Hwy 76, Clarksville, TN 37040 | 2019-03-31 |
| 1730640566 | Latoya Ewert | Counselor | Centerstone Clarksville Harriet Cohn Center, 511 8th Street, Clarksville, TN 37040 | 2019-03-26 |
| 1356811988 | Jamie Coles | Behavior Technician | 851 Professional Park Drive 851 Profesiional Park Drive, Clarksville, TN 37040 | 2018-11-27 |
| 1518448554 | Bandel Counseling Service | Clinic/Center | 113 3rd St., Suite 25, Clarksville, TN 37040 | 2018-08-28 |
| 1477052520 | Bridget Stokes | Behavior Technician | 2277 Wilma Rudolph Blvd., Suite C #259, Clarksville, TN 37040 | 2018-02-05 |
| 1053824334 | Sandra Loren Coates | Nurse Practitioner | 980 Professional Park Dr Ste C, Clarksville, TN 37040 | 2017-11-09 |
| 1902328362 | Terri Brooke Roach | Registered Nurse | 651 Dunlop Lane, Clarksville, TN 37040 | 2017-07-07 |
| 1093244428 | Nikkia Deneil Bell | Behavior Technician | 139 E. Old Trenton Rd, Suite B, Clarksville, TN 37040 | 2017-06-08 |
| Find all providers in zip 37040 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710530225 | Kaley Stinnett | Optometrist | 2801 Wilma Rudolph Blvd Ste 475, Clarksville, TN 37040-5064 | 2019-07-23 |
| 1710337365 | Joshua Houston | Optometrist | 1030 Veterans Pkwy, Clarksville, IN 47129-2354 | 2016-06-14 |
| 1528498565 | Divya Patel | Optometrist | 2801 Wilma Rudolph Blvd Ste 665, Clarksville, TN 37040-5063 | 2013-11-12 |
| 1780949693 | Jane Choi Council | Optometrist | 12345 Wake Forest Rd Ste E, Clarksville, MD 21029 | 2012-07-06 |
| 1992936892 | Tangee Melissa Davis | Optometrist | 1111 A Fort Campbell Blvd., Clarksville, TN 37042 | 2009-07-27 |
| 1558535302 | Dr David S Greene | Optometrist | 337 Madison St, Clarksville, GA 30523 | 2008-04-14 |
| 1750482659 | Mark Bruce Givens | Optometrist | 2801 Wilma Rudolph Blvd, Suite #100, Clarksville, TN 37040-5011 | 2006-09-26 |
| 1235143538 | Dr. Mark Lynn & Associates, Pllc | Optometrist | 516 E Lewis and Clark Pkwy, Clarksville, IN 47129-1700 | 2006-07-29 |
| 1821002650 | Brian Roy Murray | Optometrist | 621 N Riverside Dr, Sites Vision Clinic, Clarksville, TN 37040 | 2006-07-28 |
| 1558387258 | Matthew Theodore Drew | Optometrist | 1111a Fort Campbell Blvd, Clarksville, TN 37042-6426 | 2006-07-14 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 37040 |
Please comment or provide details below to improve the information on ALYSSA JACKSON.
| 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.