DR. CHAD HARMAN JACKSON (NPI# 1184067498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184067498 |
| Entity Type | Individual |
| Full Name | DR. CHAD HARMAN JACKSON |
| Credential | MD |
| Practice Address |
111 W Main St Ste 200 Boise ID 83702-7308 |
| Practice Telephone | 2083443220 |
| Practice Fax Number | 2083440461 |
| Mailing Telephone | 2083443220 |
| Mailing Fax Number | 2083440461 |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2020-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | M-15230 | ID | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | 67198 | WI | Allopathic & Osteopathic Physicians |
| N | 207WX0200X |
Ophthalmology Specialization: Ophthalmic Plastic and Reconstructive Surgery |
18691 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1184067498 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4502 Medical Dr, San Antonio, TX 782294402 | 2105678406 | |
| 925 N 87th St, Milwaukee, WI 532264812 | (414) 456-2020 | 4144566300 |
| 5435 Reno Corporate Dr Ste 100, Reno, NV 895112250 | 7753223311 | 7753228388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881257178 | Chad Walker Jackson | Social Worker | 7709 Riverview Dr Apt 104, Jenison, MI 49428-7960 | 2019-04-22 |
| 1518484245 | Chad Edwin Jackson | Preventive Medicine | 14110 Six Mile Cypress Pkwy, Fort Myers, FL 33912-4314 | 2017-08-24 |
| 1710177142 | Chad William Jackson | Physical Therapist | 822 S Walnut St, Maryville, MO 64468-2565 | 2007-08-01 |
| 1780772533 | Chad J Jackson | Optometrist | 6575 Belding Rd Ne, Suite D, Rockford, MI 49341-7418 | 2006-10-10 |
| 1255706438 | Chad Jackson | Chore Provider | 2021 40th Ave, Tuscaloosa, AL 35401-3930 | 2015-12-14 |
| 1316329667 | Chad Jackson | Counselor | 3225 1st Ave N, Billings, MT 59101-2104 | 2015-06-23 |
| 1467773481 | Chad T Jackson | Physician Assistant | 1001 E 2nd St, Coudersport, PA 16915-8161 | 2010-06-14 |
| 1063582120 | Chad M Jackson | Dentist | #5 Eureka Circle, Suite A, Wichita Falls, TX 76308 | 2006-11-08 |
| 1386678191 | Chad Michael Jackson | Specialist | 1747 Medical Center Pkwy, Suite 210, Murfreesboro, TN 37129-2563 | 2006-07-10 |
| Street Address |
111 W MAIN ST STE 200 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-7308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003819459 | Mark J Boerner | Ophthalmology | 111 W Main St Ste 200, Boise, ID 83702-7308 | 2005-05-31 |
| 1255401436 | Idaho Eyelid & Facial Plastic Surgery, Pllc | Optometrist | 111 W Main St Ste 200, Boise, ID 83702-7308 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295050110 | Ali Torab Parhiz | Ophthalmology | 901 N Curtis Rd Ste 302, Boise, ID 83706-1341 | 2010-04-03 |
| 1720248305 | James Benjamin Earl | Ophthalmology | 13923 W. Wainwright Dr Ste 301, Boise, ID 83713 | 2008-06-17 |
| 1891868006 | Gregory J Kent | Ophthalmology | 901 N Curtis Rd Suite 302, Boise, ID 83706 | 2006-11-16 |
| 1386739928 | Mark D Borup | Ophthalmology | 999 N. Curtis Road, Suite 205, Boise, ID 83706 | 2006-10-03 |
| 1578657094 | Kathryn M Fethke | Ophthalmology | 999 N. Curtis, Suite 205, Boise, ID 83706 | 2006-10-02 |
| 1386738839 | Katherine A Lee | Ophthalmology | 100 E. Idaho St, Suite 311, Boise, ID 83712 | 2006-10-02 |
| 1912091455 | Molly J Mannschreck | Ophthalmology | 999 N. Curtis Rd, Suite 205, Boise, ID 83706 | 2006-10-02 |
| 1679582282 | Justin Rodney Johnsen | Ophthalmology | 909 S Allante Pl, Boise, ID 83709 | 2006-08-05 |
| 1891731014 | Francois D Trotta | Ophthalmology | 128 E Mallard Dr, Boise, ID 83706-3975 | 2006-06-22 |
| 1417916586 | Adam C Reynolds | Ophthalmology | 999 N Curtis Rd Ste 205, Boise, ID 83706-1316 | 2006-03-18 |
| Find all providers in BOISE | ||||
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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.