PORSHAI JUANICE JACKSON (NPI# 1356990022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356990022 |
| Entity Type | Individual |
| Full Name | PORSHAI JUANICE JACKSON |
| Practice Address |
6341 Derryfield Dr Charlotte NC 28213-5532 |
| Practice Telephone | 9802308248 |
| Mailing Telephone | 9802308248 |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
6341 DERRYFIELD DR |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28213-5532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194288241 | Tonya Denise Farmer | Nurse Practitioner | 620 Tom Hunter Road, Charlotte, NC 28213 | 2019-04-06 |
| 1447743331 | April Neville | Counselor | 2442 Ryerson Ct, Charlotte, NC 28213 | 2018-06-14 |
| 1194234328 | Specialized Health Care Services | Case Management | 2750 E. Wt Harris Blvd, Suite 128, Charlotte, NC 28213 | 2017-09-19 |
| 1871016816 | Monarch | Occupational Therapist | 1810 Back Creek Drive, Charlotte, NC 28213 | 2017-07-21 |
| 1609306778 | Mackenzie Cashman Precht | Physician Assistant | 2225 E W T Harris Blvd Unit B, Charlotte, NC 28213 | 2017-06-12 |
| 1861939118 | Nensi Pandya | Pharmacist | 10227 University City Blvd, Charlotte, NC 28213 | 2017-01-25 |
| 1952721458 | Morgan Washington | Specialist/Technologist | 2336 Comfrey Court, Charlotte, NC 28213 | 2014-04-23 |
| 1992132393 | Midway Healthcare | Home Health | 6003 Dovetree Lane Suite D, Charlotte, NC 28213 | 2013-09-30 |
| 1932445178 | Zachary Gachogu Kariuki | Counselor | 10417 Round Leaf Drive, Charlotte, NC 28213 | 2012-12-17 |
| 1962747675 | Crystal Cherie Simmons | Counselor | 13724 Riding Hill Ave, Charlotte, NC 28213 | 2012-12-06 |
| Find all providers in zip 28213 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881257046 | Sonja Allen | Prosthetist | 3509 David Cox Rd, Charlotte, NC 28269-2281 | 2019-04-15 |
| 1346803509 | Felicia Nicole Long | Prosthetist | 221 E Exmore St Ste D, Charlotte, NC 28217-1808 | 2019-04-15 |
| 1609439868 | Latarsha Cooper | Prosthetist | 9711 David Taylor Dr Apt 228, Charlotte, NC 28262-2376 | 2019-04-15 |
| 1104399070 | Nattya S Pilgreen | Prosthetist | 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 | 2019-01-03 |
| 1255724423 | Dana Cannon | Prosthetist | 2805 South Blvd, Charlotte, NC 28209-1801 | 2015-03-12 |
| 1912006628 | Mark L Elgart | Prosthetist | 2001 E 7th St, Suite I, Charlotte, NC 28204-3311 | 2006-09-21 |
| 1306496187 | Travis Barlow | Prosthetist | 2826 Randolph Rd Ste 201, Charlotte, NC 28211-1359 | 2019-09-13 |
| 1306334792 | Matthew Earl Glover | Prosthetist | 220 Westinghouse Blvd Ste 405, Charlotte, NC 28273-4260 | 2018-05-01 |
| 1114310281 | Xquisite Xtensions | Prosthetist | 2805 South Blvd, Charlotte, NC 28209-1801 | 2015-03-12 |
| 1386817336 | Kerr Scott Wheatley | Prosthetist | 411 Billingsley Rd Ste 104, Charlotte, NC 28211-1066 | 2008-04-10 |
| Find all providers in CHARLOTTE | ||||
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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.