DR. MEGHAN GENELLE JACKSON (NPI# 1407984768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407984768 |
| Entity Type | Individual |
| Full Name | DR. MEGHAN GENELLE JACKSON |
| Credential | MD |
| Practice Address |
3030 Randolph Rd Suite 102 Charlotte NC 28211-1368 |
| Mailing Address |
Po Box 602478 Charlotte NC 28260-2478 |
| Practice Telephone | 7045124475 |
| Practice Fax Number | 7045124476 |
| Mailing Telephone | 7045124475 |
| Mailing Fax Number | 7045124476 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2013-07-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 135728 | NC | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 2009-01006 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5911939 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518599786 | Meghan E Jackson | Clinic/Center | 781 Bayridge Blvd, Willowick, OH 44095-4241 | 2020-02-06 |
| 1811543804 | Meghan Jackson | Social Worker | 223 Lancaster Way, Richmond Hill, GA 31324-4458 | 2019-08-14 |
| 1740832906 | Meghan Reid Jackson | Specialist/Technologist | 777 Summer Breeze Dr, Baton Rouge, LA 70810-6187 | 2019-07-09 |
| 1861719726 | Meghan E Jackson | Physical Therapist | 29255 Northwestern Hwy., Suite 300, Southfield, MI 48034-5742 | 2010-04-30 |
| 1336703974 | Meghan Nicole Jackson | Nurse Practitioner | 21297 Olean Blvd Ste A, Port Charlotte, FL 33952-6704 | 2019-04-29 |
| 1558870774 | Meghan T Jackson | Counselor | 1100 New Britain Ave Ste 201, West Hartford, CT 06110-2447 | 2017-09-20 |
| 1225450422 | Meghan Jackson | Skilled Nursing Facility | 13550 S Outer 40 Rd, Chesterfield, MO 63017-5812 | 2014-01-08 |
| 1316235286 | Meghan Durrett Jackson | Speech-Language Pathologist | 2924 Brook Rd, Children's Hospital of Richmond, Richmond, VA 23220-1215 | 2011-07-13 |
| Street Address |
3030 RANDOLPH RD SUITE 102 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28211-1368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053312082 | Kevin Williams | Physician Assistant | 3030 Randolph Rd, Ste 200, Charlotte, NC 28211-1368 | 2005-08-01 |
| 1679946800 | Julia Warden | Dietitian, Registered | 3030 Randolph Rd, Ste 200, Charlotte, NC 28211-1368 | 2015-11-10 |
| 1174931034 | Brandlyn Noftsger | Nurse Practitioner | 3030 Randolph Rd, Charlotte, NC 28211-1368 | 2014-07-23 |
| 1528478468 | Anna Kowalczyk-kim | Pediatrics | 3030 Randolph Rd, Ste 102, Charlotte, NC 28211-1368 | 2014-04-30 |
| 1811335482 | Reena Mehta | Physician Assistant | 3030 Randolph Rd, Suite 200, Charlotte, NC 28211-1368 | 2013-06-05 |
| 1780936799 | Vivien Haupt | Nurse Practitioner | 3030 Randolph Rd, Ste 102, Charlotte, NC 28211-1368 | 2012-10-15 |
| 1639425796 | Carolinas Physicians Network Inc | Internal Medicine | 3030 Randolph Rd, Ste 105, Charlotte, NC 28211-1368 | 2012-07-26 |
| 1629363619 | Adrian Hurst | Internal Medicine | 3030 Randolph Rd, Ste 200, Charlotte, NC 28211-1368 | 2011-06-17 |
| 1427374487 | Mecklenburg Medical Group | Internal Medicine | 3030 Randolph Rd, Ste 200, Charlotte, NC 28211-1368 | 2010-04-15 |
| 1639359276 | Kimberly Mims | Psychiatry & Neurology | 3030 Randolph Rd, Ste 200, Charlotte, NC 28211-1368 | 2007-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184277832 | I and J Wheelchair Transportation | Non-emergency Medical Transport (VAN) | 1512 Delane Avenue, Charlotte, NC 28211 | 2019-07-22 |
| 1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
| 1649798273 | Ally Home Care Charlotte LLC | In Home Supportive Care | 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 | 2017-09-04 |
| 1154866770 | Vaibhav Bajaj | Dentist | 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 | 2017-01-05 |
| 1508254939 | Lindsay Marie Smits | Speech-Language Pathologist | 427 N. Wendover Rd., Charlotte, NC 28211 | 2015-01-08 |
| 1457755480 | Kristen Hammer | Physical Therapy Assistant | 4120 Providence Rd Apt D, Charlotte, NC 28211 | 2014-10-20 |
| 1669805610 | Carla Elizabeth Scott | Physical Therapist | 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 | 2013-08-14 |
| 1760726368 | Jill Hensdale Shipp | Social Worker | 307 Hunter Lane, Charlotte, NC 28211 | 2012-11-20 |
| 1346592722 | Danielle Marie Benoit | Occupational Therapist | 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 | 2012-10-09 |
| 1487910832 | John Joseph Marcel Jr. | Orthopaedic Surgery | 449 North Wendover Rd Ste A, Charlotte, NC 28211 | 2012-04-10 |
| Find all providers in zip 28211 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619582343 | Carolinas Physicians Network Inc | Pediatrics | 9908 Couloak Dr Ste 103, Charlotte, NC 28216-8678 | 2020-09-10 |
| 1861004426 | Carolinas Physicians Network Inc | Pediatrics | 4501 Cameron Valley Pkwy Ste 200-b, Charlotte, NC 28211-4297 | 2020-08-17 |
| 1568082212 | Kidzcare Pediatrics, PC | Pediatrics | 416 Mccullough Dr Ste 140, Charlotte, NC 28262-4390 | 2020-04-23 |
| 1881222404 | Victoria Marie Carvajal | Pediatrics | Cmc/levine's Children's Hospital 1000 Blythe Blvd, 4th Floor, Meb, Charlotte, NC 28203-8812 | 2020-03-30 |
| 1386271930 | Irina Maria Geiculescu | Pediatrics | 1000 Blythe Blvd Fl 4 Meb, Charlotte, NC 28203 | 2020-03-24 |
| 1407488349 | Beth A Scisciani | Pediatrics | 8654 Walsham Dr, Charlotte, NC 28277-1850 | 2020-02-09 |
| 1962042416 | Carolinas Physicians Network Inc | Pediatrics | 1308 Scott Ave, Charlotte, NC 28204-2918 | 2020-01-13 |
| 1083175533 | Denise Makala | Pediatrics | 1000 Blythe Blvd 4th Floor, Meb, Cmc/levine Children's Hospital, Charlotte, NC 28203-5812 | 2019-03-27 |
| 1639565526 | Emily Ogletree | Pediatrics | 8401 Medical Plaza Dr Ste 220, Charlotte, NC 28262-8700 | 2015-04-08 |
| 1811392343 | Adriana Virginia Rosado-jimenez | Pediatrics | 10340 Park Rd Ste B, Charlotte, NC 28210-8401 | 2014-10-27 |
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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.