KYANA L JACKSON (NPI# 1356859995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356859995 |
| Entity Type | Individual |
| Full Name | KYANA L JACKSON |
| Practice Address |
133 N Main St Centerville OH 45459-4620 |
| Practice Telephone | 9374333931 |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2018-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | OH | Other Service Providers |
| Street Address |
133 N MAIN ST |
| City | CENTERVILLE |
| State | OH |
| Zip Code | 45459-4620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184180531 | Nicole Lynn Griffith | Peer Specialist | 133 N Main St, Centerville, OH 45459-4620 | 2019-02-11 |
| 1114432069 | Kathy A Lewis | Peer Specialist | 133 N Main St, Centerville, OH 45459-4620 | 2017-12-13 |
| 1891226262 | Friends of The Castle, Inc. | Community/Behavioral Health | 133 N Main St, Centerville, OH 45459-4620 | 2017-03-27 |
| 1508088717 | Lisa Hansford | Social Worker | 133 N Main St, Centerville, OH 45459-4620 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659917466 | Sarai Burke Robinson | Occupational Therapist | 2200 Miami Valley Rd, Dayton, OH 45459 | 2019-11-27 |
| 1689179855 | Paragon Infusion Therapy, LLC | Durable Medical Equipment & Medical Supplies | 1746 Thomas Paine Pkwy, Centerville, OH 45459 | 2018-03-28 |
| 1922555473 | Hannah Gualtieri | Specialist/Technologist | Miami Valley Drive, Suite 320, Centerville, OH 45459 | 2016-09-01 |
| 1326410028 | Kathleen E Dorsten | Counselor | 37 Irongate Park Dr, Centerville, OH 45459 | 2015-10-21 |
| 1184000846 | Valeriya Falkenshtern | Specialist/Technologist | 2400 Miami Valley Drive, Newborn Hearing Screens, Dayton, OH 45459 | 2015-08-05 |
| 1700169331 | Monica Lynn Carrico | Registered Nurse | 7625 Paragon Road Suite C, Dayton, OH 45459 | 2011-09-20 |
| 1427360080 | Tonia S Campbell | Physical Therapist | 1235 E. Alex Bell Road, Centerville, OH 45459 | 2010-07-11 |
| 1265768956 | Health At Home, LLC | Home Health | 6443 Bethany Village Drive, Dayton, OH 45459 | 2009-10-30 |
| 1881826337 | Annetta Jean Davis | Social Worker | 7950 Clyo Road, Centerville, OH 45459 | 2009-08-18 |
| 1740459783 | Ryan A Long | Dentist | 2591 Miamisburg-centerville Rd, Suite 200, Dayton, OH 45459 | 2008-02-25 |
| Find all providers in zip 45459 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184180531 | Nicole Lynn Griffith | Peer Specialist | 133 N Main St, Centerville, OH 45459-4620 | 2019-02-11 |
| 1114432069 | Kathy A Lewis | Peer Specialist | 133 N Main St, Centerville, OH 45459-4620 | 2017-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508318 | Rosemarie Czechanski | Peer Specialist | 163 E Bridge St Apt 308, Berea, OH 44017-2187 | 2020-11-03 |
| 1396345989 | Kyle Johnston | Peer Specialist | 10525 Clifton Blvd Apt 3, Cleveland, OH 44102-1586 | 2020-11-01 |
| 1053911792 | Ryan Caleb Thomason | Peer Specialist | 3554 Raymont Blvd, University Heights, OH 44118-2604 | 2020-10-30 |
| 1104425883 | David Lashore Thomas | Peer Specialist | 55 W Bagley Rd, Berea, OH 44017-1916 | 2020-10-22 |
| 1871192039 | Terra Lynn Davis | Peer Specialist | 1074 Larkens Way, Medina, OH 44256-1277 | 2020-10-20 |
| 1972101012 | Cindy Ann Kozlik | Peer Specialist | 600 W.superior Ave, Cleveland, OH 44113 | 2020-10-12 |
| 1053918565 | Tina Louise Neal | Peer Specialist | 3637 Green Rd, Cleveland, OH 44122-5779 | 2020-10-07 |
| 1326645805 | Kristen Krajewski | Peer Specialist | 3105 Woodbridge Ave, Cleveland, OH 44109-2175 | 2020-10-07 |
| 1659978500 | Brandy Dawn Altop | Peer Specialist | 9221 Hooper Rd, Athens, OH 45701-3365 | 2020-10-05 |
| 1649887993 | Patricia A Mairet | Peer Specialist | 23 W College Ave, Springfield, OH 45504-2506 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
| City | CENTERVILLE |
| Zip Code | 45459 |
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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.