DR. ALVIN DERON JACKSON (NPI# 1346228038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346228038 |
| Entity Type | Individual |
| Full Name | DR. ALVIN DERON JACKSON |
| Credential | M.D. |
| Practice Address |
106 E Broad St Savannah GA 31401-2917 |
| Practice Telephone | 9125271000 |
| Mailing Telephone | 9125271097 |
| Mailing Fax Number | 9125271126 |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2019-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 066163 | GA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 35064673 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003172519C | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3101 Burnet Ave, Cincinnati, OH 452293014 | 5133577289 | 5133523939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861915852 | Alvin Glen Jackson | Counselor | 495 East Main Street, Columbus, OH 43215 | 2017-07-21 |
| 1922349950 | Alvin Jackson | Community Health Worker | 8414 Glencross St, Houston, TX 77061-2314 | 2013-03-15 |
| Street Address |
106 E BROAD ST |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31401-2917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013552504 | Anquetta Monique Cooper | Dental Hygienist | 106 E Broad St, Savannah, GA 31401-2917 | 2019-11-08 |
| 1225672041 | Victoria D Forbes | Dental Hygienist | 106 E Broad St, Savannah, GA 31401-2917 | 2019-11-05 |
| 1225689540 | Tonya Davis | Dental Hygienist | 106 E Broad St, Savannah, GA 31401-2917 | 2019-09-27 |
| 1467967877 | Laquita Holt | Dentist | 106 E Broad St, Savannah, GA 31401-2917 | 2017-12-07 |
| 1366963837 | Wendelyn Monique Brown | Nurse Practitioner | 106 E Broad St, Savannah, GA 31401-2917 | 2017-07-05 |
| 1346776002 | Nancy Flategraff | Nurse Practitioner | 106 E Broad St, Savannah, GA 31401-2917 | 2017-05-02 |
| 1689109266 | Torrie Charell Battle | Dentist | 106 E Broad St, Savannah, GA 31401-2917 | 2017-04-20 |
| 1447798988 | Michelle Dubberly-hobart | Nurse Practitioner | 106 E Broad St, Savannah, GA 31401-2917 | 2017-02-04 |
| 1649714981 | Adrian Elam | Nurse Practitioner | 106 E Broad St, Savannah, GA 31401-2917 | 2016-12-06 |
| 1982055653 | Antwenette Charae Smith | Nurse Practitioner | 106 E Broad St, Savannah, GA 31401-2917 | 2016-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760031470 | Leslie Beatrice Dixon | Technician | 1109 Harmon Street, Savannah, GA 31401 | 2019-09-05 |
| 1912444621 | Sarah Kristen Shuman | Counselor | 140 East 40th St, Savannah, GA 31401 | 2017-01-20 |
| 1427591791 | Catherine Naomi Spann | Licensed Practical Nurse | 107 B Fahm Street, Savannag, GA 31401 | 2016-11-18 |
| 1871952499 | Jesline Palmer | Case Manager/Care Coordinator | 466 Martin Luther King Blvd, Savanah, GA 31401 | 2016-02-11 |
| 1487012894 | Suzanne Waltman Coote | Social Worker | 127 Abercorn St, Suite 301b, Savannah, GA 31401 | 2016-02-01 |
| 1356748032 | Beverly Weaver | Registered Nurse | 107 B Fahm St., Savannah, GA 31401 | 2014-11-25 |
| 1275938011 | Olukemi Olubajo | Dietitian, Registered | 125 Fahm Street, J C Lewis Primary Health Care Center, Savannah, GA 31401 | 2014-10-22 |
| 1346642279 | Kristin Jaski | Social Worker | 127 Abercorn St, Suite 301b, Savannah, GA 31401 | 2014-09-23 |
| 1528497500 | Kathleen Alice Flynn | Nurse Practitioner | 1900 Abercorn Street, Suite 100, Savannah, GA 31401 | 2013-11-11 |
| 1306112248 | Elizabeth Windom Stewart | Nurse Practitioner | 300 Bull St Ste 102, Savannah, GA 31401 | 2012-03-26 |
| Find all providers in zip 31401 | ||||
| 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 |
|---|---|---|---|---|
| 1871192260 | Ashley Willingham | Family Medicine | 210 Carlisle Way, Savannah, GA 31419-6606 | 2020-10-18 |
| 1881200772 | My Nurse Now, LLC | Family Medicine | 7070 Hodgson Memorial Dr, Savannah, GA 31406-2529 | 2020-09-16 |
| 1164052189 | Privia Medical Group of Georgia LLC | Family Medicine | 340 Eisenhower Dr Ste 1200, Savannah, GA 31406-2675 | 2020-01-17 |
| 1093289431 | Mosaic Medical Center - Maryville | Family Medicine | 301 E Price Ave Ste A, Savannah, MO 64485-2482 | 2019-01-18 |
| 1841769718 | Regenerative Healthcare, LLC | Family Medicine | 329 Eisenhower Dr Ste D, Savannah, GA 31406-2695 | 2018-11-20 |
| 1588105142 | Hamzah Telemed, LLC | Family Medicine | 35 Barnard St Ste 300, Savannah, GA 31401-2515 | 2017-03-16 |
| 1033598479 | Erica Blaikie Young | Family Medicine | 51 Johnny Mercer Blvd. Cottage A-1, Savannah, GA 31410 | 2015-05-19 |
| 1770989048 | Global Health Delivery, Inc. | Family Medicine | 361 Commercial Dr Ste B, Savannah, GA 31406-3643 | 2014-11-13 |
| 1215273123 | John Marion Fillingim | Family Medicine | 716 E 52nd St, Savannah, GA 31405-3604 | 2012-12-20 |
| 1619236205 | David Medical Enterprises | Family Medicine | 3840 Waters Avenue, I Care Family Medicine Clinic, Savannah, GA 31404-6264 | 2012-05-16 |
| Find all providers in SAVANNAH | ||||
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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.