COREY JERROD JACKSON (NPI# 1427432343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427432343 |
| Entity Type | Individual |
| Full Name | COREY JERROD JACKSON |
| Credential | NP |
| Practice Address |
601 Elmwood Ave Rochester NY 14642-0001 |
| Mailing Address |
601 Elmwood Ave Box Hmd Rochester NY 14642-0001 |
| Practice Telephone | 5852754912 |
| Practice Fax Number | 5852762144 |
| Mailing Telephone | 5857849842 |
| Mailing Fax Number | 5854278718 |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 702343 | NY | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
342473 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 978 Clinton Ave S, Rochester, NY 146202040 | 5855761144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972873321 | Corey N Jackson | Contractor | 130 Mankin Pl, La Vergne, TN 37086-3048 | 2012-01-03 |
| 1659419075 | Corey Lamont Jackson Sr. | Chiropractor | 1518 S Poplar St, Pine Bluff, AR 71601-6249 | 2007-02-01 |
| 1215395637 | Corey Jackson | Health Educator | 100 Chambers St, Cumberland, RI 02864-7724 | 2016-01-30 |
| 1154735611 | Corey Jackson | Physical Therapist | 1551 N Rock Rd, Wichita, KS 67206-1255 | 2014-06-12 |
| 1558672881 | Corey E Jackson | Physical Therapist | 917 Beville Rd, Suite G, South Daytona, FL 32119-1712 | 2010-07-01 |
| 1669693032 | Corey Alan Jackson | Orthopaedic Surgery | 3373 Commerce Pkwy Ste 2, Wooster, OH 44691-7130 | 2007-05-01 |
| 1194866707 | Corey Jai Jackson | Counselor | 3995 Marcola Rd, Springfield, OR 97477-7948 | 2007-02-08 |
| Street Address |
601 ELMWOOD AVE |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14642-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324317 | Marc Norman Berliant | Internal Medicine | 601 Elmwood Ave, Box Med, Rochester, NY 14642-0001 | 2005-05-23 |
| 1386245165 | Stephanie Pilat | Pharmacist | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-11-06 |
| 1396346276 | Noah Ritzel | Physician Assistant | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-11-05 |
| 1811598790 | Natalie Tanke | Registered Nurse | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-11-05 |
| 1891394490 | Muhamed Ahmic | Nurse Anesthetist, Certified Registered | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-10-23 |
| 1619576543 | Patricia Marie Reiber | Nurse Practitioner | 601 Elmwood Ave, Rochester, NY 14642-0002 | 2020-10-21 |
| 1528667557 | Alexandra Jessie Strutt | Nurse Practitioner | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-10-21 |
| 1750989323 | Sarah Jones | Physician Assistant | 601 Elmwood Ave, Rochester, NY 14642-0002 | 2020-10-15 |
| 1679171334 | Audrey Linn Schroeder | Genetic Counselor, MS | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2020-10-15 |
| 1013515568 | Carla Katherine Muranyi | Nurse Practitioner | 601 Elmwood Ave, Rochester, NY 14642-0002 | 2020-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679192363 | Nicholas Campbell Love | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave, Ac-5, General Medicine Clinic 696, Rochester, NY 14642 | 2020-04-13 |
| 1750900650 | Phillip Braun | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave, Ac-5 General Medicine Clinic 696, Rochester, NY 14642 | 2020-04-10 |
| 1437786993 | Andrew Jeong | Student in an Organized Health Care Education/Training Program | Department of Orthopaedics and Rehabilitation, 601 Elmwood Avenue, Rochester, NY 14642 | 2020-03-25 |
| 1497227094 | Alison Kent | Pediatrics | Dept of Pediatrics, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642 | 2018-12-20 |
| 1326539909 | Saumya Goel Aujla | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave # 664, Rochester, NY 14642 | 2018-05-19 |
| 1922505387 | Daniel Bral | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave # 655, Rochester, NY 14642 | 2018-04-11 |
| 1194222513 | Jonah Meyerhoff | Student in an Organized Health Care Education/Training Program | 300 Crittenden Blvd Department of Psychiatry, Rochester, NY 14642 | 2018-04-11 |
| 1144738949 | Francis Michael Manzo | Registered Nurse | University of Rochester 601 Elmwood Ave Box Surg, Rochester, NY 14642 | 2018-01-15 |
| 1225552649 | George Norman Abraham | Internal Medicine | 600 Elmwood Avenue, University of Rochester, Rochester, NY 14642 | 2017-07-27 |
| 1861928301 | Sonia Thakur | Student in an Organized Health Care Education/Training Program | 601 Elmwood University of Rochester Medical Center, Department of Physicial Medicine and Rehabilitation, Rochester, NY 14642 | 2017-05-03 |
| Find all providers in zip 14642 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091704 | Morgan Rohl | Nurse Practitioner | 117 12th Ave Nw Apt 2, Rochester, MN 55901-2787 | 2020-10-21 |
| 1073111738 | Melissa E Spencer | Nurse Practitioner | 1338 E Ridge Rd Ste 101, Rochester, NY 14621-2017 | 2020-10-15 |
| 1295345254 | Kristin Colleen Fleming | Nurse Practitioner | 400 Red Creek Dr Ste 110, Rochester, NY 14623-4273 | 2020-08-05 |
| 1043820251 | Michelle Katherine Hiczun | Nurse Practitioner | 20 Hagen Dr Ste 330, Rochester, NY 14625-2664 | 2020-08-03 |
| 1689296949 | Suzanne Lee Bundrick | Nurse Practitioner | 1921 Westwood Ct Sw, Rochester, MN 55902-1170 | 2020-05-09 |
| 1649818931 | Erin Elizabeth Akins | Nurse Practitioner | 1882 Winton Rd S Ste 3, Rochester, NY 14618-3950 | 2019-12-17 |
| 1912544107 | Bethany Anderson Ganz | Nurse Practitioner | 115 16th Ave Nw, Rochester, MN 55901-0347 | 2019-12-06 |
| 1164068383 | Christina Kosachook | Nurse Practitioner | 990 South Ave Ste 104, Rochester, NY 14620-2740 | 2019-11-22 |
| 1073159679 | Avellina Ihuaku Okafor | Nurse Practitioner | 1328 Ridgeway Ave, Rochester, NY 14615-3716 | 2019-11-19 |
| 1053961409 | Melissa Guu-shyuan Feng | Nurse Practitioner | 995 Senator Keating Blvd Ste 3100, Rochester, NY 14618-2778 | 2019-09-18 |
| Find all providers in ROCHESTER | ||||
Please comment or provide details below to improve the information on COREY JERROD JACKSON.
| 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.