KELLY LEN JACKSON (NPI# 1174761498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174761498 |
Entity Type | Individual |
Full Name | KELLY LEN JACKSON |
Other Name | KELLY LEN BRANDENBERGER |
Credential | N.P. |
Practice Address |
5670 Peachtree Dunwoody Rd Ne Suite 1000 Atlanta GA 30342-1699 |
Practice Telephone | 4042551930 |
Practice Fax Number | 4042551939 |
Mailing Telephone | 4042551930 |
Mailing Fax Number | 4042551939 |
Enumeration Date | 2009-01-23 |
Last Update Date | 2010-02-14 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WX0200X |
Registered Nurse Specialization: Oncology |
RN143526 | GA | Nursing Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588036263 | Kelly Jackson | Social Worker | 2937 Ne 16th Ter, Gainesville, FL 32609-3234 | 2015-10-21 |
1477896876 | Kelly A Jackson | Occupational Therapist | 178 Manila Ave, Staten Island, NY 10306-5608 | 2013-04-03 |
1104986793 | Kelly A Jackson | Chiropractor | 190 North Main Street, Natick, MA 01760 | 2006-12-12 |
1518982487 | Kelly Donald Jackson | Dentist | 3023 Eastland Blvd Ste 112, Clearwater, FL 33761-4106 | 2006-07-13 |
1689273310 | Kelly Jackson | Behavior Technician | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5312 | 2020-10-23 |
1629544655 | Kelly Colleen Jackson | Counselor | 811 Madison St, Everett, WA 98203-4543 | 2018-10-17 |
1619457926 | Kelly Jackson | Physician Assistant | 12300 Mccracken Rd, Garfield Heights, OH 44125-2975 | 2018-08-16 |
1760961833 | Kelly D Jackson | Licensed Practical Nurse | 602 W Semands St, Conroe, TX 77301-1867 | 2018-08-09 |
1841780178 | Kelly Amanda Jackson | Nurse Practitioner | 1700 Medical Center Pkwy, Murfreesboro, TN 37129-2245 | 2018-05-11 |
1033653431 | Kelly Jackson | Nurse Practitioner | 606 W Columbia St, San Augustine, TX 75972-1709 | 2016-12-05 |
Street Address |
5670 PEACHTREE DUNWOODY RD NE SUITE 1000 |
City | ATLANTA |
State | GA |
Zip Code | 30342-1699 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790784080 | Scott Jeffrey Small | Internal Medicine | 5670 Peachtree Dunwoody Rd Ne, Suite 1200, Atlanta, GA 30342 | 2005-07-19 |
1619214343 | Kalos Surgical Associates LLC | Otolaryngology | 5670 Peachtree Dunwoody Rd Ne, Ste 910, Atlanta, GA 30342-1699 | 2013-01-15 |
1497006555 | Nsh Cancer Institute Professional Services A LLC | Durable Medical Equipment & Medical Supplies | 5670 Peachtree Dunwoody Rd Ne, Suite 1100, Atlanta, GA 30342-1699 | 2012-09-28 |
1215288378 | Nsh Cancer Institute Professional Services A LLC | Pharmacy | 5670 Peachtree Dunwoody Rd Ne, Suite 1100, Atlanta, GA 30342-1699 | 2012-09-28 |
1376843003 | Northside Cardiology-electrophysiology, LLC | Internal Medicine | 5670 Peachtree Dunwoody Rd Ne, Suite 880, Atlanta, GA 30342-1699 | 2010-10-28 |
1225277809 | Meghan Meyer Williams | Physician Assistant | 5670 Peachtree Dunwoody Rd Ne, Suite 920, Atlanta, GA 30342-1699 | 2009-02-05 |
1982864443 | Karen D Cowan | Nurse Practitioner | 5670 Peachtree Dunwoody Rd Ne, Suite 880, Atlanta, GA 30342-1699 | 2008-06-09 |
1548444045 | Kelly Ann May | Internal Medicine | 5670 Peachtree Dunwoody Rd Ne, Suite 1100, Atlanta, GA 30342-1699 | 2007-12-20 |
1144412883 | Megan Christina Sweet | Physician Assistant | 5670 Peachtree Dunwoody Rd Ne, Suite 1000, Atlanta, GA 30342-1699 | 2007-08-16 |
1811187107 | Diana Derry | Audiologist | 5670 Peachtree Dunwoody Rd Ne, Suite 1280, Atlanta, GA 30342-1699 | 2007-08-01 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
1255945184 | Jennifer Lynne Cole | Behavior Technician | 5555 Glenridge Con Suite 200, Atlanta, GA 30342 | 2020-09-08 |
1093336232 | Van Tran | Respiratory Therapist, Registered | 1000 Johnson Ferry Rd Ne, Atlanta, Ga 30342, Atlanta, GA 30342 | 2020-04-28 |
1356978340 | Twyla Douglas Jackson I | Clinical Nutrition, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 | 2020-03-27 | |
1760013411 | Emily Hamm | Dietitian, Registered | 933 D Johnson Ferry Road, Suite 250, Atlanta, GA 30342 | 2020-01-31 |
1043855984 | Mackenzie Tucker Wayda | Registered Nurse | 1001 Johnson Ferry Rd. Ne, Atlanta, GA 30342 | 2019-11-14 |
1386288454 | Tiauna Lashun Cochman | Psychologist | 1307 Glenridge Dr, Sandy Springs, GA 30342 | 2019-11-01 |
1164074399 | Stephen J. White | Hearing Instrument Specialist | 5775 Peachtree Dunwoody Rd Suite 600 Fl. 6, Uhc Hearing, Atl., GA 30342 | 2019-07-09 |
1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
1760954705 | Mishele Walker LLC | Counselor | 555 Glenridge Connector, Suite 200, Sandy Springs, GA 30342 | 2018-12-31 |
Find all providers in zip 30342 |
Taxonomy Code | 163WX0200X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Oncology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235597337 | Alice S Kerber | Registered Nurse | 50 Hurt Plz Se, Suite 704, Atlanta, GA 30303-2946 | 2016-02-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376180430 | Marie Daniella Perez | Registered Nurse | 112 Lee Ave, Leesburg, GA 31763-4117 | 2019-12-06 |
1730780073 | Mojisola Mary Bakare | Registered Nurse | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-11-03 |
1477994804 | Lisa Clair Logue | Registered Nurse | 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834 | 2013-07-15 |
1710327176 | Jennifer Fournier | Registered Nurse | 225 Candler Dr, Suite 204, Savannah, GA 31405-6023 | 2013-07-01 |
1003041104 | Barbara O'callaghan | Registered Nurse | 631 Professional Drive, 450, Lawrenceville, GA 30046-7651 | 2009-05-19 |
1861627028 | Theresa Lynn Catlin | Registered Nurse | 631 Professional Drive, Suite 450, Lawrenceville, GA 30046-7651 | 2009-05-18 |
1881841047 | Jennifer M Butler | Registered Nurse | 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834 | 2008-08-19 |
1184820128 | Sherry Annice Davis | Registered Nurse | 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834 | 2007-06-26 |
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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.