CORY DAVID JACKSON (NPI# 1194340687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194340687 |
| Entity Type | Individual |
| Full Name | CORY DAVID JACKSON |
| Credential | FNP-BC |
| Practice Address |
212 Allendale Dr Forest City NC 28043-2889 |
| Mailing Address |
5507 Shawnee Dr Huntington WV 25705-3305 |
| Practice Telephone | 8282457626 |
| Mailing Telephone | 3046900320 |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WE0003X |
Registered Nurse Specialization: Emergency |
96293 | WV | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
96293 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578060448 | Cory Lynn Jackson | Case Manager/Care Coordinator | 1 Nome Bypass Road, Nome, AK 99762-0966 | 2018-04-09 |
| 1962969295 | Cory Jackson | Behavior Technician | 3031 C St, Sacramento, CA 95816-3326 | 2019-02-22 |
| 1609365170 | Cory Daniel Jackson | Student in an Organized Health Care Education/Training Program | 20 York St, New Haven, CT 06510-3220 | 2018-05-09 |
| Street Address |
212 ALLENDALE DR |
| City | FOREST CITY |
| State | NC |
| Zip Code | 28043-2889 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811954258 | Lynda M Lachance | Family Medicine | 212 Allendale Dr, Forest City, NC 28043-2889 | 2006-04-28 |
| 1114526316 | Janet Bennie | Nurse Practitioner | 212 Allendale Dr, Forest City, NC 28043-2889 | 2020-10-20 |
| 1003265943 | Anna Philbeck Burgess | Nurse Practitioner | 212 Allendale Dr, Forest City, NC 28043-2889 | 2016-06-10 |
| 1750763876 | Kelly Reyna Radford | Family Medicine | 212 Allendale Dr, Forest City, NC 28043 | 2015-06-25 |
| 1912387267 | Megan E. Mase | Family Medicine | 212 Allendale Dr, Forest City, NC 28043 | 2015-06-02 |
| 1962821322 | Dlp Rutherford Physician Practices LLC | Podiatrist | 212 Allendale Dr, Forest City, NC 28043-2889 | 2014-04-14 |
| 1952731010 | Robin Schoenfeldt | Nurse Practitioner | 212 Allendale Dr, Forest City, NC 28043-2889 | 2013-11-26 |
| 1235432154 | Rhonda Brooks Hill | Registered Nurse | 212 Allendale Dr, Forest City, NC 28043 | 2010-12-15 |
| 1770686743 | Rutherford Hospital, Inc. | Clinic/Center | 212 Allendale Dr, Forest City, NC 28043-2889 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528475530 | Lori Hammond West | Pharmacist | 139 East Main St, Forest City, NC 28043 | 2014-07-22 |
| 1982989943 | Hope Care Center, Inc. | Assisted Living Facility | 136 Yelton's Circle, Forest City, NC 28043 | 2011-10-20 |
| 1770804643 | Brandi R Holtsclaw | Physical Therapist | 2270 Us Hwy 74a Suite 341, Onesource Rehab, Forest City, NC 28043 | 2010-06-15 |
| 1093944217 | New Start of The Piedmont Inc. | Community/Behavioral Health | 331 South. Broadway Street., Forest City, NC 28043 | 2009-07-09 |
| 1568690493 | Directcare Community Based Services, LLC | Community/Behavioral Health | 129 First Street, Forest City, NC 28043 | 2009-06-30 |
| 1760663058 | Americare Developmental Services | Residential Treatment Facility, Emotionally Disturbed Children | 313 Harrill Rd, Forest City, NC 28043 | 2007-11-15 |
| 1255529038 | Respiratory At Home Plus, Corp. | Durable Medical Equipment & Medical Supplies | 338 Withrow Road, Suite D, Forest City, NC 28043 | 2007-10-05 |
| 1821129362 | K D Support Services / Kelly's Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 158 Us Highway 221a, Forest City, NC 28043 | 2007-03-08 |
| 1407986714 | Americas Living Centers LLC | Custodial Care Facility | 128 Country Meadows Lane, Forest City, NC 28043 | 2007-03-06 |
| 1821157256 | Hopewell Care Inc. | Assisted Living Facility | 141 Fox Run, Forest City, NC 28043 | 2006-12-08 |
| Find all providers in zip 28043 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811477383 | Tamara Sue Price | Nurse Practitioner | 635 E Us Hwy 9, Forest City, IA 50436-1028 | 2018-08-15 |
| 1114526316 | Janet Bennie | Nurse Practitioner | 212 Allendale Dr, Forest City, NC 28043-2889 | 2020-10-20 |
| 1386282598 | Rebekah Blumenthal | Nurse Practitioner | 635 E Us Highway 9, Forest City, IA 50436-1028 | 2019-12-18 |
| 1518516491 | Nicole Crotts Scruggs | Nurse Practitioner | 374 Hudlow Rd, Forest City, NC 28043-9444 | 2019-09-04 |
| 1841742608 | Kristin Hamrick Austin | Nurse Practitioner | 281 E Main St, Forest City, NC 28043-3126 | 2016-10-27 |
| 1003265943 | Anna Philbeck Burgess | Nurse Practitioner | 212 Allendale Dr, Forest City, NC 28043-2889 | 2016-06-10 |
| 1154779460 | Molly Eichenberger | Nurse Practitioner | 635 E Us Highway 9, Forest City, IA 50436-1028 | 2016-05-26 |
| 1578975546 | Susan Harris | Nurse Practitioner | 374 Hudlow Rd, Forest City, NC 28043-9444 | 2014-05-27 |
| 1952731010 | Robin Schoenfeldt | Nurse Practitioner | 212 Allendale Dr, Forest City, NC 28043-2889 | 2013-11-26 |
| 1972845204 | Alan D Ancillotti | Nurse Practitioner | 197 Plaza Dr, Forest City, NC 28043-3712 | 2013-03-25 |
| Find all providers in FOREST CITY | ||||
| City | FOREST CITY |
| Zip Code | 28043 |
Please comment or provide details below to improve the information on CORY DAVID 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.