MICHAEL JACKSON (NPI# 1215091723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215091723 |
| Entity Type | Individual |
| Full Name | MICHAEL JACKSON |
| Credential | OD |
| Practice Address |
1850 Adams St Ste 112 Mankato MN 56001-4846 |
| Mailing Address |
11103 West Ave Suite 6 San Antonio TX 78213-1370 |
| Practice Telephone | 5073876358 |
| Practice Fax Number | 5073874166 |
| Mailing Telephone | 2105246663 |
| Mailing Fax Number | 2105246587 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2460 | MN | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295345346 | Michael Frederick Jackson | Massage Therapist | 12702 E 33rd Ct, Spokane Valley, WA 99206-8372 | 2020-08-04 |
| 1295372993 | Michael Jackson | Chiropractor | 5216 Cold Springs Way, Eugene, OR 97405-5213 | 2019-12-02 |
| 1801365382 | Michael Jackson | Durable Medical Equipment & Medical Supplies | 5537b N Glenwood St Ste B, Garden City, ID 83714-1336 | 2018-11-14 |
| 1114441375 | Michael Frank Jackson Jr. | Physical Therapist | 1806 Russell Pkwy Ste 1400, Warner Robins, GA 31088-5781 | 2017-07-31 |
| 1457809931 | Michael Jackson | Counselor | 10001 W. Grand Avenue, Franklin Park, IL 60131 | 2016-09-14 |
| 1639625833 | Michael Jackson | Counselor | 128 Mute Swan Place, Newark, DE 19711 | 2016-08-28 |
| 1467823104 | Michael Jackson | Occupational Therapy Assistant | 1913 N Oakes St Apt D, Tacoma, WA 98406-7527 | 2015-10-07 |
| 1831576651 | Michael Howard Jackson | Family Medicine | 4646 Nw Fielding Road, Topeka, KS 66618 | 2015-04-30 |
| 1063809846 | Michael Jackson | Social Worker | 43518 Champlain Ct, Canton, MI 48188-1711 | 2015-04-20 |
| 1780922872 | Michael A Jackson | Pharmacist | 585 Mcwilliams Rd Se Unit 2303, Atlanta, GA 30315-7571 | 2013-01-23 |
| Street Address |
1850 ADAMS ST STE 112 |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-4846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891862231 | Thomas Warner Dull | Optometrist | 1850 Adam St Suite 005 Sears Optical, Thomas W Dull, Mankato, MN 56001 | 2006-11-29 |
| 1811075401 | Jean M Tasler | Optometrist | 1819 Adams St, Mankato, MN 56001-4841 | 2006-11-01 |
| 1225116932 | Carlson Tillisch Eye Clinic, Ltd | Optometrist | 120 N Broad St, Mankato, MN 56001-3518 | 2006-11-01 |
| 1316974967 | Dale L Carlson | Optometrist | 220 East Main, Mankato, MN 56002-3387 | 2006-06-27 |
| 1467404210 | Rachael Suzanne Potter | Optometrist | 1820 E Madison Ave, Mankato, MN 56001-5448 | 2006-05-17 |
| 1386626794 | Albert Ray Lamotte | Optometrist | 111 Star St, Suite 101, Mankato, MN 56001-4888 | 2005-11-20 |
| 1376049031 | Murphy Grotewold | Optometrist | 220 E Main St, Mankato, MN 56001 | 2018-04-02 |
| 1790149003 | Laura Goemann | Optometrist | 1400 Madison Ave Ste 338, Mankato, MN 56001-5465 | 2016-04-12 |
| 1447586987 | Nathaniel Lee Graham | Optometrist | 1421 Premier Dr, Mankato, MN 56001-6076 | 2009-10-18 |
| 1538398250 | Angela Michelle Johnson | Optometrist | 1400 E Madison Ave, Suite 338, Mankato, MN 56001-5473 | 2009-07-02 |
| Find all providers in MANKATO | ||||
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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.