KENNETH DOLEN JACKSON (NPI# 1295898179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295898179 |
| Entity Type | Individual |
| Full Name | KENNETH DOLEN JACKSON |
| Credential | MD |
| Practice Address |
930 Carondelet Dr Suite 104 Kansas City MO 64114-4855 |
| Mailing Address |
930 Carondelet Dr 201 Kansas City MO 64114-4698 |
| Practice Telephone | 8169412222 |
| Practice Fax Number | 8169412282 |
| Mailing Telephone | 8169412222 |
| Mailing Fax Number | 8169412282 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2015-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | 9406666 | KS | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 2008033152 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174083810 | Kenneth Jason Jackson | Student in an Organized Health Care Education/Training Program | 320 23rd St S Apt 1418, Arlington, VA 22202-3773 | 2019-03-20 |
| 1639469026 | Kenneth T Jackson | Counselor | 25506 Virginia Dr, Warren, MI 48091-6002 | 2011-04-19 |
| 1396968863 | Kenneth J Jackson | Dentist | 809 Redskin Trail, Wapakoneta, OH 45895 | 2007-04-11 |
| 1972510352 | Kenneth Wayne Jackson | Nurse Practitioner | 1811 Memorial Dr, Clarksville, TN 37043-4604 | 2006-08-01 |
| 1487606943 | Kenneth Wade Jackson Jr. | Obstetrics & Gynecology | 22 Manningfield Dr, Fletcher, NC 28732-9457 | 2006-05-16 |
| 1275514994 | Kenneth Conrad Jackson II | Pharmacist | 546 Chipeta Way, Suite 220, Salt Lake City, UT 84108-1236 | 2005-11-09 |
| 1407409063 | Kenneth Jackson | Technician | 1005 Terminal Way Ste 125, Reno, NV 89502-2198 | 2019-07-22 |
| 1457857690 | Kenneth D Jackson | Counselor | 2775 State Route 39, Shelby, OH 44875-9466 | 2018-04-05 |
| 1528573714 | Kenneth Jackson | Case Manager/Care Coordinator | 1501 Madison Rd, Walnut Hills, OH 45206-1706 | 2017-12-10 |
| 1003328550 | Kenneth Lee Jackson Jr. | Counselor | 1430 S High St Fl 4, Columbus, OH 43207-1045 | 2017-10-24 |
| Street Address |
930 CARONDELET DR SUITE 104 |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64114-4855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556512 | Paula Louise Eaton | Obstetrics & Gynecology | 930 Carondelet Dr, Ste 304, Kansas City, MO 64114-4698 | 2005-05-23 |
| 1588197982 | Alicia M Shuker | Nurse Practitioner | 930 Carondelet Dr, Ste 201, Kansas City, MO 64114 | 2017-04-04 |
| 1669849956 | Omer Leroy | Nurse Practitioner | 930 Carondelet Dr, Ste 201, Kansas City, MO 64114 | 2015-08-21 |
| 1306220447 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 930 Carondelet Dr, Kansas City, MO 64114-4855 | 2015-07-18 |
| 1659778264 | Physicians Reference Laboratory LLC | Clinical Medical Laboratory | 930 Carondelet Dr, Bldg C Ste 201, Kansas City, MO 64114-4855 | 2014-11-25 |
| 1982018719 | Carondelet Physician Services, Inc | Family Medicine | 930 Carondelet Dr, Suite 304, Kansas City, MO 64114-4855 | 2014-06-19 |
| 1881934768 | Lab One LLC | Clinical Medical Laboratory | 930 Carondelet Dr, Suite 200, Kansas City, MO 64114-4855 | 2013-02-28 |
| 1376717181 | Kay Hamilton | Nurse Practitioner | 930 Carondelet Dr, Suite 302, Kansas City, MO 64114-4855 | 2008-04-14 |
| 1497933626 | Norman I Bamber | Neurological Surgery | 930 Carondelet Dr, Suite 300, Kansas City, MO 64114-4855 | 2008-02-11 |
| 1942320767 | Mohsin Quinn Soliman | Surgery | 930 Carondelet Dr, Suite 104, Kansas City, MO 64114-4855 | 2007-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164055968 | Nova Home Infusion, LLC | Home Infusion | 7611 State Line Road, Suite 130 B, Kansas City, MO 64114 | 2020-02-20 |
| 1770011017 | Rene Thomsen | Counselor | 222 W Gregory Blvd Ste 120, Kansas City, MO 64114 | 2017-05-31 |
| 1114452075 | Accent Home Health Care LLC | In Home Supportive Care | 7817 Wornall Rd, Kansas City, MO 64114 | 2017-04-27 |
| 1174982599 | Mei Dodson | Contractor | 8901 Washington St, Kansas City, MO 64114 | 2016-02-12 |
| 1851784805 | Sarah Jeannette Gulledge | Registered Nurse | 930 Carondelet Dr., Suite 201, Kansas City, MO 64114 | 2015-03-16 |
| 1376936591 | Corey Bess | Podiatrist | 1010 Carondelet Dr Ste 301, Kansas City, MO 64114 | 2015-03-12 |
| 1013339753 | Kati Mayer | Physical Therapist | 10008 Walnut Dr., #202, Kansas City, MO 64114 | 2014-01-15 |
| 1619270311 | Gavett Burch | Marriage & Family Therapist | 222 W Gregory Blvd., Suite #319, Kansas City, MO 64114 | 2010-12-18 |
| 1679873046 | Ken Kidd Inc Dba Miracle-ear | Hearing Instrument Specialist | 1148 W. 103rd St, Kansas City, MO 64114 | 2010-11-01 |
| 1316264161 | Elizabeth Vasquez | Physician Assistant | 1004 Carondelet Dr., Suite 330, Kansas City, MO 64114 | 2010-05-03 |
| Find all providers in zip 64114 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851886949 | Adam Kahle | Surgery | 4000 Cambridge, Department of Surgery, M/s 2005, Kansas City, KS 66160 | 2018-06-29 |
| 1184910028 | Elizabeth Catherine Butler | Surgery | 5820 Nw Barry Rd Ste 300, Kansas City, MO 64154-2578 | 2011-06-20 |
| 1629256235 | Saint Luke's Hospital Physician Billing Services, LLC | Surgery | 4323 Wornall Road, Peet Center Level 3, Kansas City, MO 64111 | 2008-02-06 |
| 1326259623 | Joshua Matthew Varghise Mammen | Surgery | 3901 Rainbow Blvd 4000 Murphy, University of Kansas Medical Center, Department of Surg, Kansas City, KS 66103-2937 | 2007-05-25 |
| 1033141635 | Karthik Vamanan | Surgery | 4320 Wornall Rd Ste 50, Kansas City, MO 64111-5943 | 2006-07-06 |
| 1437185543 | Robert J Kenney Jr. | Surgery | 5844 Nw Barry Rd Ste 120, Kansas City, MO 64154-1483 | 2006-06-23 |
| 1912951518 | Surgical Consultants of Kansas City, P C | Surgery | 1010 Carondelet Dr Ste 114, Kansas City, MO 64114-4821 | 2006-05-19 |
| 1780243741 | Brian Cummiskey | Surgery | 3901 Rainbow Blvd, Kansas City, KS 66160-8500 | 2019-06-12 |
| 1922663988 | Gabrielle Rico | Surgery | 1750 Independence Ave, Kansas City, MO 64106-1453 | 2019-05-06 |
| 1376004945 | Derek Ryan Marlor | Surgery | 3901 Rainbow Blvd, Kansas City, KS 66160-8500 | 2019-03-27 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 64114 |
Please comment or provide details below to improve the information on KENNETH DOLEN JACKSON.
| 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.