DOUGLAS JACKSON (NPI# 1184277857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184277857 |
| Entity Type | Individual |
| Full Name | DOUGLAS JACKSON |
| Credential | NP |
| Practice Address |
1100 Reid Pkwy Richmond IN 47374-1157 |
| Mailing Address |
1100 Reid Parkway Medical Staff Service Richmond IN 47374 |
| Practice Telephone | 7659833000 |
| Practice Fax Number | 7659358944 |
| Mailing Telephone | 7659355331 |
| Mailing Fax Number | 7659833219 |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2020-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71009145A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730384744 | Douglas Reed Jackson | Neuromusculoskeletal Medicine & OMM | 3211 Applewood Rd, Midland, MI 48640-2666 | 2007-06-19 |
| 1245367655 | Douglas Wayne Jackson | Dentist | 5540 S 79th E Place, Tulsa, OK 74145-7846 | 2007-02-27 |
| 1457401762 | Douglas Jackson | Dentist | 714 E. 4th Ave, Red Springs, NC 28377 | 2007-01-11 |
| 1063432342 | Douglas R Jackson | Family Medicine | 517 W Junipero St Unit 1, 334 S Patterson Ave #120, Santa Barbara, CA 93105-4239 | 2006-07-20 |
| 1760412241 | Douglas Gilbert Jackson I | Nurse Practitioner | 14827 Foothill Rd, Santa Paula, CA 93060-9733 | 2006-07-03 |
| 1962472407 | Douglas T Jackson | Anesthesiology | 150 Bargen St, F 102, Newark, NJ 07103 | 2006-01-26 |
| 1427394147 | Douglas Ray Jackson | Pharmacist | 600 Sheldon St, Creston, IA 50801-3322 | 2012-12-27 |
| 1891071635 | Douglas Scott Jackson | Pharmacist | 116 S George St, Suite 101, York, PA 17401-1474 | 2011-10-25 |
| 1013160316 | Douglas Clarence Jackson | Specialist | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2008-10-30 |
| 1912076639 | Douglas L Jackson | Nurse Anesthetist, Certified Registered | 100 Peyton Way, Suite 200, Charleston, WV 25309-8572 | 2006-11-07 |
| Street Address |
1100 REID PKWY |
| City | RICHMOND |
| State | IN |
| Zip Code | 47374-1157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801891189 | Michael J Buckmaster | Surgery | 1100 Reid Pkwy, Suite 215, Richmond, IN 47374-1157 | 2005-06-14 |
| 1740888288 | David J Warwick | Nurse Practitioner | 1100 Reid Pkwy, Richmond, IN 47374-1157 | 2020-10-16 |
| 1366040065 | Adebisi Mary Adeyemi | Student in an Organized Health Care Education/Training Program | 1100 Reid Pkwy, Richmond, IN 47374-1157 | 2020-10-14 |
| 1629688890 | Zachary Hayes | Nurse Practitioner | 1100 Reid Pkwy, Richmond, IN 47374-1157 | 2020-08-03 |
| 1326667684 | Ibrahim Ali Khan | Student in an Organized Health Care Education/Training Program | 1100 Reid Pkwy, Richmond, IN 47374-1157 | 2020-04-15 |
| 1215566575 | Jonathan A Adams | Student in an Organized Health Care Education/Training Program | 1100 Reid Pkwy, Richmond, IN 47374-1157 | 2020-04-07 |
| 1003445958 | Kimberly Carhuatanta | Student in an Organized Health Care Education/Training Program | 1100 Reid Pkwy, Richmond, IN 47374-1157 | 2020-04-03 |
| 1942839717 | Abdallah Saleh | Student in an Organized Health Care Education/Training Program | 1100 Reid Pkwy, Richmond, IN 47374-1157 | 2020-04-03 |
| 1851920748 | Dustin Cundiff | Student in an Organized Health Care Education/Training Program | 1100 Reid Pkwy, Richmond, IN 47374-1157 | 2020-04-03 |
| 1861021735 | Waiel Almardini | Student in an Organized Health Care Education/Training Program | 1100 Reid Pkwy, Richmond, IN 47374-1157 | 2020-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245724566 | Meridian Health Services Corp | Substance Abuse Rehabilitation Facility | 498 Nw 18th St., Bldg. 416, Suite A, Richmond, IN 47374 | 2018-06-20 |
| 1699274472 | Happy Hearts Home Care Corp | In Home Supportive Care | 335 Sw 17th Street, Richmond, IN 47374 | 2018-02-07 |
| 1922528504 | Erin A Chung | Internal Medicine | 1050 Reid Parkway, Suite 300, Reid Hospital Family Medicine Residency, Richmond, IN 47374 | 2017-06-23 |
| 1023538899 | Andrea Dengler | Registered Nurse | 1501 Chester Blvd., Reid Urgent Care, Richmond, IN 47374 | 2017-06-22 |
| 1497284186 | Lindsay A Worley | Nurse Practitioner | 1050 Reid Pkwy, Ste. 325, Urological Care, Richmond, IN 47374 | 2017-06-07 |
| 1689112039 | Shantil Dickerson | Physical Therapist | 22 Nw 11th St., Richmond, IN 47374 | 2017-02-06 |
| 1073058772 | Meridian Health Services Corp | Substance Abuse Rehabilitation Facility | 498 Nw 18th St Bldg 416, Richmond, IN 47374 | 2017-01-04 |
| 1538564216 | Lauren Joos | Physician Assistant | 1380 Lakeview Court, Richmond, IN 47374 | 2014-10-23 |
| 1588074421 | Emily Rutherford | Pharmacist | 2057 Chester Blvd, Richmond, IN 47374 | 2014-04-30 |
| 1922357870 | Elizabeth Ann Mullins | Social Worker | 301 South 4th St., Richmond, IN 47374 | 2012-09-06 |
| Find all providers in zip 47374 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962038570 | Samantha Montgomery Warren | Nurse Practitioner | 3900 Westerre Parkway, Suite 300 Pmb# 308, Richmond, VA 23233 | 2020-03-15 |
| 1053956508 | Ihechi Ngozi Nwosuocha | Nurse Practitioner | 20010 Ballinger Ridge Ct, Richmond, TX 77407-4057 | 2019-11-07 |
| 1154976314 | Amanda Piper | Nurse Practitioner | 2200 Pump Rd Ste 200, Richmond, VA 23233-3539 | 2019-08-05 |
| 1083273676 | Winifred Onyali | Nurse Practitioner | 11222 Oudney Ct, Richmond, TX 77407-1883 | 2019-06-07 |
| 1740759182 | Houssam Mahmoud Mozeyen | Nurse Practitioner | 5719 Indigo Trails Dr, Richmond, TX 77469 | 2018-11-15 |
| 1801365168 | Rosmond Adams Oberry | Nurse Practitioner | 7101 Jahnke Rd Ste 550s, Richmond, VA 23225-4017 | 2018-11-15 |
| 1780166090 | Todd A Johnson | Nurse Practitioner | 21530 Barrett Knolls Dr, Richmond, TX 77406-5300 | 2018-09-04 |
| 1053892844 | Christina Lack | Nurse Practitioner | 5855 Bremo Rd Ste 208, Richmond, VA 23226-1922 | 2018-08-28 |
| 1073002580 | Oyebola Temitope Oyekan | Nurse Practitioner | 7615 Northfork Hollow Ln, Richmond, TX 77407-2285 | 2018-05-09 |
| 1851897763 | Eno Ubaha | Nurse Practitioner | 17102 Winter Hedge Ct, Richmond, TX 77407-2602 | 2018-04-02 |
| Find all providers in RICHMOND | ||||
Please comment or provide details below to improve the information on DOUGLAS 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.