CRAIG JACKSON (NPI# 1275962581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275962581 |
| Entity Type | Individual |
| Full Name | CRAIG JACKSON |
| Practice Address |
1750 Thompson Rd Coos Bay OR 97420-2100 |
| Practice Telephone | 4074958340 |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2014-07-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD166929 | OR | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | ME117763 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659537512 | Craig Jackson | Occupational Therapy Assistant | 2423 Castlereagh Rd, Charleston, SC 29414-6134 | 2008-07-31 |
| 1992926000 | Craig Lebern Jackson | Religious Nonmedical Nursing Personnel | 4297 Wyndam Hill Dr, Suwanee, GA 30024-6525 | 2007-05-02 |
| 1386030997 | Craig Jackson | Counselor | 1409 Clark St, Des Moines, IA 50314-1964 | 2015-04-09 |
| 1750612586 | Craig Alan Jackson | Pharmacist | 10710 W Mcdowell Rd, Avondale, AZ 85392-5958 | 2010-01-18 |
| 1235192469 | Craig W Jackson | Dentist | 25 Hospital Center Blvd, Hospital Medical Pavilion, Suite 102, Hilton Head Island, SC 29926-2738 | 2006-04-10 |
| Street Address |
1750 THOMPSON RD |
| City | COOS BAY |
| State | OR |
| Zip Code | 97420-2100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922004365 | Andrew Rowe Maslona | Internal Medicine | 1750 Thompson Rd, Coos Bay, OR 97420 | 2005-06-21 |
| 1679181069 | Jodi Sue Tavernier | Case Manager/Care Coordinator | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2020-07-21 |
| 1477161206 | Sarah Brady | Case Manager/Care Coordinator | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2020-07-17 |
| 1508490400 | Trisha Gederos | Social Worker | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2020-02-28 |
| 1568096188 | Heath Gerig | Nurse Practitioner | 1750 Thompson Rd, Coos Bay, OR 97420-2100 | 2020-02-24 |
| 1710527726 | Sara Ferrell | Social Worker | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2020-01-08 |
| 1295245108 | Davina Lynn Bledsoe | Family Medicine | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2017-10-05 |
| 1518312362 | Sarah Marie Strawn | Acupuncturist | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2016-04-29 |
| 1982088464 | Alex Michael Spencer | Surgery | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2015-07-15 |
| 1720483266 | Jason Hayes | Nurse Practitioner | 1750 Thompson Rd, Coos Bay, OR 97420-2100 | 2014-10-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880606 | Danielle Goette | Massage Therapist | 320 Central Ave Suite 226, Coos Bay, OR 97420 | 2020-01-14 |
| 1730643735 | Nicole Hand-therapeutic Massage | Massage Therapist | 3229 Broadway Avenue, Suite D, Coos Bay, OR 97420 | 2019-01-24 |
| 1528531100 | A Better Reality | Clinic/Center | 2690 N. 17th Sstreet, Coos Bay, OR 97420 | 2019-01-07 |
| 1396216883 | Elizabeth Rose Stephens | Health Educator | 97381 Newport Lane, Coos Bay, OR 97420 | 2018-12-10 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1285091884 | Richard T Rigney | Counselor | 62754 Karl Road, Coos Bay, OR 97420 | 2016-01-27 |
| 1821493032 | James Thomas Agee | Pharmacist | 2051 Newmark Avenue, Walmart Pharmacy 1880, Coos Bay, OR 97420 | 2014-10-30 |
| 1346663895 | Steven D. Richardson D.m.d. L.l.c | Dentist | 1835 Ocean Blvd Se, Coos Bay, OR 97420 | 2014-02-03 |
| 1144669243 | Michael Jason Cole | Pharmacist | 1020 South First Ave, Coos Bay, OR 97420 | 2013-06-21 |
| 1639518053 | Jonathan Thomas Small | Physical Therapist | 2645 North 17th St, Coos Bay, OR 97420 | 2013-06-19 |
| Find all providers in zip 97420 | ||||
| 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 |
|---|---|---|---|---|
| 1477501815 | Roger Cecil Willis | Family Medicine | 600 Miluk Drive, Coos Bay, OR 97420 | 2006-05-05 |
| 1518941350 | Robert William Gerber | Family Medicine | 2690 N 17th St, Coos Bay, OR 97420 | 2005-12-05 |
| 1295245108 | Davina Lynn Bledsoe | Family Medicine | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2017-10-05 |
| 1891170502 | Alyssa Sader | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2015-07-23 |
| 1447538533 | Samir Bir Ale | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2011-07-24 |
| 1831342773 | Eduardo Erasto Santiago Ongkeko | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2008-10-23 |
| 1932216751 | James Alan Maddox | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2099 | 2006-08-25 |
| 1184638124 | Jennifer Laurel Webster | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2006-07-27 |
| 1821047192 | Linda Marie Smith | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2006-05-06 |
| 1083684773 | Celeste Blanken | Family Medicine | 1900 Woodland Dr, Coos Bay, OR 97420-2045 | 2006-01-25 |
| Find all providers in COOS BAY | ||||
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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.