GARRETT J JACKSON (NPI# 1336381631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336381631 |
| Entity Type | Individual |
| Full Name | GARRETT J JACKSON |
| Credential | M.D. |
| Practice Address |
3750 Landmark Dr Suite B Lafayette IN 47905-6652 |
| Mailing Address |
3750 Landmark Dr Ste B Lafayette IN 47905-6652 |
| Practice Telephone | 7654487981 |
| Practice Fax Number | 7654474172 |
| Mailing Telephone | 3173961300 |
| Mailing Fax Number | 3173293040 |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2019-12-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 01074880A | IN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | WV | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922367515 | Garrett Rodney Jackson | Chiropractor | 1258 Bryan Rd, O Fallon, MO 63366-3771 | 2012-05-16 |
| Street Address |
3750 LANDMARK DR SUITE B |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905-6652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073531257 | Samuel Horton | Psychiatry & Neurology | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-07-17 |
| 1407231442 | Rachel Erin Pennington | Specialist/Technologist, Other | 3750 Landmark Dr, Suite B, Lafayette, IN 47905-6652 | 2015-07-20 |
| 1437583390 | Susan Lynne Blakemore | Nurse Practitioner | 3750 Landmark Dr, Lafayette, IN 47905-6652 | 2013-08-28 |
| 1417169244 | Patricia Ann Beaty | Physical Therapist | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6652 | 2007-05-04 |
| 1932286481 | Thomas Bridge | Family Medicine | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
| 1639256191 | Wasima Hassan | Family Medicine | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
| 1487731964 | Thomas Petry | Family Medicine | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
| 1457438830 | James Watson | Family Medicine | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
| 1386721777 | Ramona Bass | Nurse Practitioner | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
| 1477630853 | Karla Ross | Nurse Practitioner | 3750 Landmark Dr, Suite A, Lafayette, IN 47905-6633 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
| 1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
| 1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
| 1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
| Find all providers in zip 47905 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821336918 | Paul Harvey Chodroff | Neurological Surgery | 925 Reliez Station Rd, Lafayette, CA 94549-4827 | 2013-01-23 |
| 1700072238 | Jayme Trahan | Neurological Surgery | 1000 W Pinhook Rd Ste 305, Lafayette, LA 70503-2460 | 2007-09-18 |
| 1578784468 | William A. Brennan | Neurological Surgery | 4212 W Congress Street, Suite 3500, Lafayette, LA 70506-6765 | 2007-05-01 |
| 1528183027 | Nancy Lynn Rogers | Neurological Surgery | 798 East Farrel Road, Lafayette, LA 70508 | 2007-03-21 |
| 1508925926 | Cavett M. Robert Jr. | Neurological Surgery | 3959 Canyon Rd, Lafayette, CA 94549-2701 | 2006-12-08 |
| 1740397306 | Ilyas Munshi | Neurological Surgery | 99 W Martial Ave, Lafayette, LA 70508-6583 | 2006-08-23 |
| 1730106410 | Erick Stephanian | Neurological Surgery | 3750 Landmark Dr Ste B, Lafayette, IN 47905-6652 | 2006-07-17 |
| 1528014586 | Luiz C Dearaujo | Neurological Surgery | 116 Hospital Dr, Suite A, Lafayette, LA 70503-2819 | 2006-05-25 |
| 1750336111 | Ricardo R Leoni | Neurological Surgery | 203 Rue Louis Xiv, Suite B, Lafayette, LA 70508-5736 | 2006-05-24 |
| 1417438631 | Ahmad Moustafa Elakil | Neurological Surgery | 1200 Camellia Blvd, Lafayette, LA 70508-6163 | 2018-08-25 |
| Find all providers in LAFAYETTE | ||||
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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.