LASANDRA D JACKSON (NPI# 1356429674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356429674 |
| Entity Type | Individual |
| Full Name | LASANDRA D JACKSON |
| Credential | MD |
| Practice Address |
2755 S Highway 14 Suite 2200 Greer SC 29650-4902 |
| Mailing Address |
Po Box 419402 Boston MA 02241-9402 |
| Practice Telephone | 8648499555 |
| Practice Fax Number | 8648499556 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2019-07-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 20289 | SC | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 0101240815 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 202890 | 05 | |
| VA | GROUP PTAN | C09633 | 01 |
| VA | GROUP PTAN | C06695 | 01 |
| Street Address |
2755 S HIGHWAY 14 SUITE 2200 |
| City | GREER |
| State | SC |
| Zip Code | 29650-4902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538164546 | Surgery Center At Pelham, LLC | Clinic/Center | 2755 S Highway 14, Greer, SC 29650-4926 | 2005-06-16 |
| 1598111353 | Spartanburg Medical Center | Nurse Practitioner | 2755 S Highway 14, Suite 2200, Greer, SC 29650-4902 | 2016-05-11 |
| 1972963494 | Spartanburg Medical Center | Physical Medicine & Rehabilitation | 2755 S Highway 14, Suite 1450, Greer, SC 29650-4902 | 2016-02-25 |
| 1245608934 | Spartanburg Medical Center | Dermatology | 2755 S Highway 14, Suite 2050, Greer, SC 29650-4902 | 2015-09-11 |
| 1114302767 | Spartanburg Medical Center | Family Medicine | 2755 S Highway 14, Suite 1200f, Greer, SC 29650-4902 | 2015-07-24 |
| 1720470206 | Spartanburg Medical Center | Allergy & Immunology | 2755 S Highway 14, Suite 1200h, Greer, SC 29650-4902 | 2015-02-20 |
| 1174940498 | Spartanburg Medical Center | Internal Medicine | 2755 S Highway 14, Suite 2500, Greer, SC 29650-4941 | 2014-03-25 |
| 1366703845 | James Baker Romine | Physician Assistant | 2755 S Highway 14, Ste 1200l, Greer, SC 29650-4902 | 2012-05-31 |
| 1659692952 | John Albert Lucas Iv | Family Medicine | 2755 S Highway 14, Suite 1200l, Greer, SC 29650-4902 | 2010-06-21 |
| 1902124050 | Jenna Elise Rolfs | Physician Assistant | 2755 S Highway 14, Suite 2200, Greer, SC 29650-4902 | 2010-05-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154946424 | Paul Wong | Family Medicine | 109 Physicians Drive Suite A, Greer, SC 29650 | 2020-06-12 |
| 1992273684 | Christopher Michael Campbell | Pharmacist | 845b S Buncombe Rd, Greer, SC 29650 | 2018-11-12 |
| 1376035618 | Jessica Miller | Dentist | 1494 W Wade Hampton Blvd Ste D, Greer, SC 29650 | 2018-06-02 |
| 1992212872 | Greenville Health Corporation | Pharmacy | 845 S Buncombe Rd Ste D, Greer, SC 29650 | 2018-01-02 |
| 1114432077 | Spartanburg Medical Center | Orthopaedic Surgery | 2755 S Highway 14 Ste 1200m, Greer, SC 29650 | 2017-12-13 |
| 1437679750 | Sanders Healthcare LLC | Home Health | 110 W. Church St., Suite A, Greer, SC 29650 | 2017-06-27 |
| 1306291117 | James Elliott Crouch | Occupational Therapy Assistant | 1305 Boilings Springs Rd., Greer, SC 29650 | 2016-04-29 |
| 1033593389 | Premier Medical Transport Service | Non-emergency Medical Transport (VAN) | 120 Glenaire Dr, Greer, SC 29650 | 2015-07-16 |
| 1104176429 | Suchi Chomal | Pharmacist | 6 Colby Ct, Greer, SC 29650 | 2012-09-13 |
| 1447500822 | John Varner | Pharmacist | 821 S. Batesville Road, Greer, SC 29650 | 2012-09-13 |
| Find all providers in zip 29650 | ||||
| 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 |
|---|---|---|---|---|
| 1841637790 | Mackenzie J Bartz | Surgery | 2755 S Highway 14 Ste 2200, Greer, SC 29650-4936 | 2013-06-03 |
| 1225359243 | Elizabeth Van Huffel Dray | Surgery | 340 Medical Pkwy Ste 200, Greer, SC 29650-2441 | 2010-06-14 |
| 1477524072 | Anita Patt | Surgery | 2759 S Highway 14, Greer, SC 29650 | 2006-01-31 |
| 1861494502 | Joseph Harold Wentzky Jr. | Surgery | 340 Medical Pkwy, Suite 200, Greer, SC 29650-2441 | 2005-08-12 |
| 1730406901 | David Ellis Disbrow | Surgery | 340 Medical Pkwy, Suite 200, Greer, SC 29650-2441 | 2010-04-28 |
| 1306044318 | Derek Steven Brenda | Surgery | 2755 S Highway 14, Suite 2500, Greer, SC 29650-4902 | 2007-07-11 |
| 1164626875 | Geetika Dembla | Surgery | 2700 E Phillips Rd, Greer, SC 29650-4815 | 2007-06-14 |
| 1235274267 | Spartanburg Medical Center | Surgery | 2755 S Highway 14, Suite2500, Greer, SC 29650-4902 | 2007-02-20 |
| 1871656256 | Spartanburg Regional Med Ctr | Surgery | 2755 S Highway 14, Hallway 300, Greer, SC 29650-4902 | 2006-12-18 |
| 1902849920 | Richard Henry Gettys Jr. | Surgery | 325 Medical Pkwy, Suite 250, Greer, SC 29650-2457 | 2006-06-14 |
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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.