TAYLOR KIYOTA JACKSON (NPI# 1275158404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275158404 |
| Entity Type | Individual |
| Full Name | TAYLOR KIYOTA JACKSON |
| Credential | OD |
| Practice Address |
5900 Keyes St Ste 101 Frederick CO 80504-5956 |
| Mailing Address |
1600 Iron Horse Dr Apt B102 Longmont CO 80501-5704 |
| Practice Telephone | 3038331056 |
| Mailing Telephone | 3039212307 |
| Enumeration Date | 2020-06-13 |
| Last Update Date | 2020-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPT0003599 | CO | Eye and Vision Services Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1600 Iron Horse Dr Apt B102, Longmont, CO 805015704 | 3039212307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194324848 | Taylor Jackson | Registered Nurse | 4255 Wildener Way, Cumming, GA 30041-3602 | 2020-10-23 |
| 1992173025 | Taylor Jackson | Specialist/Technologist | 707 E Merry Ave, Bowling Green, OH 43403-4502 | 2015-09-06 |
| 1487251302 | Taylor Leeanne Jackson | Occupational Therapist | 3710 Olentangy River Rd, Columbus, OH 43214-3426 | 2020-10-04 |
| 1215568233 | Taylor Jackson | Social Worker | 128 S 17th St, Blair, NE 68008-2004 | 2020-01-29 |
| 1376188375 | Taylor Jackson | Behavior Technician | 1317 Oakdale Rd Ste 610, Modesto, CA 95355-3365 | 2019-11-13 |
| 1265083679 | Taylor Bauer Jackson | Student in an Organized Health Care Education/Training Program | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2019-09-26 |
| 1326543752 | Taylor Jackson | Orthopaedic Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2018-03-27 |
| 1558877548 | Taylor Mae Jackson | Counselor | 515 Lakeway Dr, Bellingham, WA 98225-5233 | 2017-12-28 |
| 1700258324 | Taylor Joel Jackson | Pharmacist | 5633 N Lidgerwood St, Spokane, WA 99208 | 2015-10-22 |
| Street Address |
5900 KEYES ST STE 101 |
| City | FREDERICK |
| State | CO |
| Zip Code | 80504-5956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700018256 | Jeffrey Berger | Optometrist | 5900 Keyes St Ste 101, Frederick, CO 80504-5956 | 2009-08-18 |
| 1235558065 | Carbon Valley Eye Care | Optometrist | 5900 Keyes St Ste 101, Frederick, CO 80504-5956 | 2014-04-09 |
| 1366735201 | Michael Edward Koditek | Optometrist | 5900 Keyes St Ste 101, Frederick, CO 80504-5956 | 2011-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942776620 | Cinde S Yoho | Social Worker | 9485 County Road 15, Firestone, CO 80504 | 2018-10-19 |
| 1427544881 | Thousand Peaks Healthcare, Inc. | In Home Supportive Care | 310 Lashley St Ste 109, Longmont, CO 80504 | 2018-07-09 |
| 1962913962 | Melissa Frick | Counselor | 10184 E I-25 Frontage Rd, Firestone, CO 80504 | 2017-10-17 |
| 1558757260 | Firestone Pediatric Dentistry and Orthodontics | Dentist | 8301 Colorado Blvd, Suite 200, Firestone, CO 80504 | 2015-04-09 |
| 1912392671 | Ashley Lerwick | Speech-Language Pathologist | 11169 Interstate I25 Frontage Rd, Firestone, CO 80504 | 2015-03-31 |
| 1780077685 | Roger Leon Jorgensen | Ophthalmology | 14222 N 95 Si, Longmont, CO 80504 | 2015-03-17 |
| 1982942090 | Carrie Rose Fitzekam | Technician | 712 Tanagers Circle, Longmont, CO 80504 | 2013-01-24 |
| 1003166976 | Jennifer Lynn Mcnerney | Speech-Language Pathologist | 8197 Miller Dr, Frederick, CO 80504 | 2012-09-18 |
| 1821343450 | Allison Luellen | Physician Assistant | 8350 Colorado Blvd, Suite 160, Firestone, CO 80504 | 2012-07-19 |
| 1609132109 | Abby Elizabeth Bohall | Speech-Language Pathologist | 5132 Mt Buchanan Ave, Frederick, CO 80504 | 2012-04-09 |
| Find all providers in zip 80504 | ||||
| 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 |
|---|---|---|---|---|
| 1124650916 | National Vision Inc | Optometrist | 7256 Guilford Dr, Frederick, MD 21704-5167 | 2020-02-10 |
| 1861902959 | Kenny Chen | Optometrist | 5283 Corporate Dr Ste 201, Frederick, MD 21703 | 2017-10-03 |
| 1720436553 | Myeyedr Optometry of Maryland, LLC | Optometrist | 5500 Buckeystown Pike Ste 892, Frederick, MD 21703-9441 | 2016-06-02 |
| 1659760098 | Longmeadow Optical | Optometrist | 7420 Hayward Rd, Suite 202, Frederick, MD 21702-2507 | 2015-01-22 |
| 1972825388 | Eugene Stephan Channing | Optometrist | 166 Baughman's Lane, Channing Vision-eye Care, Inc., Frederick, MD 21702-4083 | 2010-02-26 |
| 1700018256 | Jeffrey Berger | Optometrist | 5900 Keyes St Ste 101, Frederick, CO 80504-5956 | 2009-08-18 |
| 1003083486 | Cerella F Rainey | Optometrist | 5500 Buckeystown Pike Ste 876, Frederick, MD 21703-9441 | 2008-05-14 |
| 1861683872 | Eye To Eye of Frederick Inc | Optometrist | 2060 Yellow Springs Rd Ste 104, Frederick, MD 21702-2322 | 2007-08-05 |
| 1003024795 | Channing Vision Eye Care Inc | Optometrist | 166 Baughmans Lane, Frederick, MD 21702-4083 | 2007-05-18 |
| 1386857100 | Jennifer Lyn Chen | Optometrist | 10534 Liberty Rd, Frederick, MD 21701-2626 | 2007-05-08 |
| Find all providers in FREDERICK | ||||
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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.