CORY DAVID JACKSON


Address: 212 Allendale Dr, Forest City, NC 28043-2889
Phone: 8282457626

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).

Provider Overview

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

Taxonomy

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

Other Providers CORY JACKSON

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

Office Location

Street Address 212 ALLENDALE DR
City FOREST CITY
State NC
Zip Code 28043-2889

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Competitor

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City FOREST CITY
Zip Code 28043

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Dataset Information

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.

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