RYAN CHRISTOPHER JACKSON (NPI# 1184060188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184060188 |
| Entity Type | Individual |
| Full Name | RYAN CHRISTOPHER JACKSON |
| Credential | MD |
| Practice Address |
22 Bramhall St Portland ME 04102-3134 |
| Mailing Address |
300 Southborough Dr Suite 201 South Portland ME 04106-6914 |
| Practice Telephone | 2076622381 |
| Practice Fax Number | 2076626226 |
| Mailing Telephone | 2076612000 |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2016-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | MD20548 | ME | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194281287 | Ryan Theron Jackson | Behavior Technician | 1112 Parkway Cir N, Atlanta, GA 30340-6312 | 2019-02-14 |
| 1780665539 | Ryan Daniel Jackson | Chiropractor | 324 13th St, Franklin, PA 16323-1367 | 2005-11-09 |
| 1912566035 | Ryan R Jackson | Hearing Instrument Specialist | 92 Broadway, Denville, NJ 07834-2761 | 2019-06-12 |
| 1407318223 | Ryan C Jackson | Student in an Organized Health Care Education/Training Program | 22 S Greene St Rm N3e09, Baltimore, MD 21201-1595 | 2019-04-01 |
| 1164989257 | Ryan Jackson | Occupational Therapy Assistant | 535 S Elm St, Itasca, IL 60143-2187 | 2019-02-25 |
| 1194292060 | Ryan Jackson | Pharmacist | 960 Ross St, Heflin, AL 36264-1164 | 2018-10-30 |
| 1699153130 | Ryan Patrick Jackson | Student in an Organized Health Care Education/Training Program | 300 Pasteur Dr, Rm Hc435, Mc 5207, Stanford, CA 94305-2200 | 2015-05-18 |
| 1609216316 | Ryan L Jackson | Speech-Language Pathologist | 151 Southwest Dr, Jonesboro, AR 72401-5828 | 2013-06-26 |
| 1811125131 | Ryan Michael Jackson | Pharmacist | 2501 Cornhusker Dr, South Sioux City, NE 68776-3910 | 2009-06-25 |
| 1710114582 | Ryan Scott Jackson | Otolaryngology | 4921 Parkview Pl, Ste 11a, Saint Louis, MO 63110-1032 | 2009-06-18 |
| Street Address |
22 BRAMHALL ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-3134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641355 | Suzanne Maynard | Specialist | 22 Bramhall St, Dept of Anesthesiology, Portland, ME 04102 | 2005-07-05 |
| 1902406135 | Barbara Lewis-armstrong | Social Worker | 22 Bramhall St, Portland, ME 04102-3175 | 2020-10-27 |
| 1285231217 | Malia Haddock | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-10-02 |
| 1972118222 | Morgan O'brien | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-09-14 |
| 1295349900 | Natalie Margaret Petrone | Occupational Therapist | 22 Bramhall St, Portland, ME 04102-3175 | 2020-09-01 |
| 1467065565 | Mandi Ann Horwath | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-28 |
| 1922610492 | Diana Christine Hubbell | Registered Nurse | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-17 |
| 1790393023 | Rami Waked | Student in an Organized Health Care Education/Training Program | 22 Bramhall St, Portland, ME 04102-3134 | 2020-07-22 |
| 1871117143 | Lesley Raley | Pharmacist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-06-03 |
| 1023638707 | Rebecca Naomi Glass | Physical Therapist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| Find all providers in zip 04102 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1912361718 | Bryce Edwards | Emergency Medicine | 3181 Sw Sam Jackson Park Road, Ohsu, Portland, OR 97239 | 2016-04-07 |
| 1073907978 | Karen Ta | Emergency Medicine | 10300 Se Main St, Portland, OR 97216 | 2015-03-27 |
| 1104210921 | Elizabeth Hatfield | Emergency Medicine | 3181 Sw Sam Jackson Park Rd # Cdw, Portland, OR 97239-3011 | 2015-03-19 |
| 1699171918 | Stephen Boyer | Emergency Medicine | 3708 Sw Lyle Ct, Portland, OR 97221-3963 | 2014-11-13 |
| 1679991590 | Meaghan Dehning | Emergency Medicine | 3181 Sw Sam Jackson Park Rd # Em, Portland, OR 97239-3011 | 2014-03-29 |
| 1942647185 | Jason F Hine | Emergency Medicine | E1 Clairmont Ct, Portland, ME 04103-4459 | 2013-05-29 |
| 1487900742 | Aaron Vitells | Emergency Medicine | 2424 Ne 41st Ave, Portland, OR 97212-5423 | 2012-07-24 |
| 1073870895 | Marcus Alyn Chiodo | Emergency Medicine | 10000 Se Main St Ste 40, Adventist Medical Center - The Pavilion, Portland, OR 97216-2461 | 2012-04-18 |
| 1184913147 | Jerry L Lawrence | Emergency Medicine | 11705 Nw Timberview Ln, Apt 204, Portland, OR 97229-6659 | 2011-03-30 |
| Find all providers in PORTLAND | ||||
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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.