DENNIS M JACKSON MD INC (NPI# 1194969220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194969220 |
| Entity Type | Organization |
| Organization Name | DENNIS M JACKSON MD INC |
| Practice Address |
460 Saint Michaels Dr #1005 Santa Fe NM 87505-7619 |
| Mailing Address |
5112 Hollywood Blvd #111 Pmb 106 Los Angeles CA 90027-6126 |
| Practice Telephone | 5054909738 |
| Mailing Telephone | 5054909738 |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2009-04-20 |
| Authorized Official Name | DENNIS M JACKSON (PRESIDENT) |
| Authorized Official Telephone | 5054909738 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 70142 | NM | Allopathic & Osteopathic Physicians |
| Street Address |
460 SAINT MICHAELS DR #1005 |
| City | SANTA FE |
| State | NM |
| Zip Code | 87505-7619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609808005 | Alston C Lundgren | Family Medicine | 460 Saint Michaels Dr, Ste. 801, Santa Fe, NM 87505-7619 | 2006-07-07 |
| 1801243290 | Shirley Lam | Hearing Instrument Specialist | 460 Saint Michaels Dr, Ste 901, Santa Fe, NM 87505-7619 | 2016-05-16 |
| 1043680028 | Whole Body Wellness | Specialist | 460 Saint Michaels Dr, Suite 601, Santa Fe, NM 87505-7619 | 2015-10-02 |
| 1023413788 | Tahlia Rainbolt, Phd, LLC | Community/Behavioral Health | 460 Saint Michaels Dr, Suite 505, Santa Fe, NM 87505-7619 | 2014-10-23 |
| 1245641638 | Jack Jones Hearing Center, Inc. | Audiologist-Hearing Aid Fitter | 460 Saint Michaels Dr, Ste 901, Santa Fe, NM 87505-7619 | 2014-05-19 |
| 1073856530 | Emanuel, LLC | In Home Supportive Care | 460 Saint Michaels Dr, Suite 1104, Santa Fe, NM 87505-7619 | 2013-04-03 |
| 1093055816 | Deborah Schweiger-whalen and Associates, LLC | Clinic/Center | 460 Saint Michaels Dr, Suite 1101, Santa Fe, NM 87505-7619 | 2013-02-15 |
| 1922315068 | Northland Hearing Centers Inc | Audiologist-Hearing Aid Fitter | 460 Saint Michaels Dr, Suite 1204, Santa Fe, NM 87505-7619 | 2010-09-10 |
| 1194966747 | Caroline Kingston Md Mph Family Practice LLC | Clinic/Center | 460 Saint Michaels Dr, 1204, Santa Fe, NM 87505-7619 | 2009-03-11 |
| 1215173000 | New Mexico Pain Management, LLC | General Practice | 460 Saint Michaels Dr, Building 200, Santa Fe, NM 87505-7619 | 2008-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154939031 | Enchanted Sky Hospice,llc | Hospice Care, Community Based | 1692b Hospital Drive, Vigil Office Building, Suite 201a, Santa Fe, NM 87505 | 2020-07-16 |
| 1700409968 | Caa Consulting, LLC | Clinic/Center | 1448 S St. Francis Drive, Santa Fe, NM 87505 | 2020-05-22 |
| 1104447093 | Dana Marie Tsyconyea Simmons | Counselor | 1640 Calle Medico, Suite E, Santa Fe, NM 87505 | 2020-05-01 |
| 1114574217 | Kumara Hampton Therapy, LLC | Counselor | 11 Calle Medico Suite 4, Santa Fe, NM 87505 | 2019-08-22 |
| 1245886977 | Caroline Ward | Technician | 513 Velarde St 513 Velarde St, Santa Fe, NM 87505 | 2019-08-19 |
| 1205490752 | Alyson Yacono | Physical Therapist | 104 Old Las Vegas Highway, Santa Fe, NM 87505 | 2019-04-30 |
| 1366919649 | Allyson Matthews | Speech-Language Pathologist | Santa Fe Public Schools Special Education Department, 1300 Camino Sierra Vista, Santa Fe, NM 87505 | 2018-10-25 |
| 1093280281 | Diamond Care Santa Fe LLC | Skilled Nursing Facility | 635 Harkle Road, Santa Fe, NM 87505 | 2018-10-04 |
| 1972087054 | Changing Woman Initiative | Advanced Practice Midwife | 460 Saint Michaels Drive, Suite 804, Santa Fe, NM 87505 | 2018-09-24 |
| 1154812782 | Heart Wing, LLC | Social Worker | 2724 Alamosa Drive, Santa Fe, NM 87505 | 2018-05-18 |
| Find all providers in zip 87505 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053947408 | Optimal Wellness Journey | Family Medicine | 3231 Caminito San Lucas, Santa Fe, NM 87507-0443 | 2020-03-18 |
| 1336620053 | Patricia Ann Woodall | Family Medicine | 66 Apache Plume Dr, Santa Fe, NM 87508-9384 | 2018-08-22 |
| 1417201732 | Niki Hodges | Family Medicine | 14310 Highway 6, Santa Fe, TX 77517-3421 | 2012-11-08 |
| 1891055281 | William Mccormick Bowen | Family Medicine | 5501 Herrera Dr Suite B, Christus St. Vincent Urgent Care Entrada Contenta, Santa Fe, NM 87507-2677 | 2012-05-21 |
| 1245597970 | Thomas William Longley | Family Medicine | 454 St. Michaels Drive, Santa Fe, NM 87505 | 2012-04-19 |
| 1215203385 | Joseph M Molina Md Professional Corporation-southern California Molina | Family Medicine | 1714 St. Michaels Drive, Suite #1, Santa Fe, NM 87505-6059 | 2012-03-22 |
| 1255625687 | Eric Grasser Md LLC | Family Medicine | 1925 Aspen Dr Ste 502a, Santa Fe, NM 87505-5559 | 2011-06-02 |
| 1740570175 | Stephanie V Lucero | Family Medicine | 1713 Nm 502, Santa Fe, NM 87506-8931 | 2011-04-19 |
| 1285946947 | Abbas Khoshdel | Family Medicine | 799 Camino Francisca, Santa Fe, NM 87506-6100 | 2010-07-10 |
| 1861652083 | Maria Ramirez-atamoros | Family Medicine | 431 Saint Michaels Dr Ste B, Suite B, Santa Fe, NM 87505-8606 | 2008-06-11 |
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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.