KIMBERLY NICOLE JACKSON (NPI# 1447536370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447536370 |
| Entity Type | Individual |
| Full Name | KIMBERLY NICOLE JACKSON |
| Credential | D.O. |
| Practice Address |
15655 State Route 170 Ste H Calcutta OH 43920 |
| Mailing Address |
Po Box 1663 Warren OH 44482-1663 |
| Practice Telephone | 3309320183 |
| Practice Fax Number | 3309320240 |
| Mailing Telephone | 3309320183 |
| Mailing Fax Number | 3309320240 |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2019-09-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 34.011422 | OH | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 667 Eastland Ave Se, Warren, OH 444844503 | 3308414774 | 3308414021 |
| 15655 State Route 170 Ste H, Calcutta, OH 43920 | 3309320183 | 3309320240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951394 | Kimberly Sue Jackson | Home Health Aide | 26 W Warner Rd, Coventry Township, OH 44319-1732 | 2020-10-29 |
| 1588278600 | Kimberly Jackson | Counselor | 2703 N Harrison St, Wilmington, DE 19802-2924 | 2020-09-04 |
| 1184244063 | Kimberly Jackson | Music Therapist | 121 Koeppe Dr, Sequim, WA 98382-9489 | 2020-04-21 |
| 1588293278 | Kimberly Dianne Billie Jackson | Nurse Practitioner | 940 Morningside Dr, Sumter, SC 29153-7724 | 2020-04-04 |
| 1710418355 | Kimberly Jackson | Specialist/Technologist | 2402 High Star Dr, Garland, TX 75041-3236 | 2017-03-24 |
| 1386188332 | Kimberly Jackson | Dietitian, Registered | 2318 Longcourt Way Se, Atlanta, GA 30339-0902 | 2016-12-10 |
| 1336682780 | Kimberly Marie Jackson | Nurse Practitioner | 128 Professional Park Dr Unit B, Conway, SC 29526-9260 | 2016-12-02 |
| 1639535719 | Kimberly Renee Jackson | Massage Therapist | 9175 Cypress Waters Blvd Apt 102, Coppell, TX 75019-5068 | 2016-01-05 |
| 1275934887 | Kimberly Jackson | Counselor | 213 Barrett St, Wilmington, DE 19802-2004 | 2014-09-15 |
| 1972930279 | Kimberly Jackson | Nurse's Aide | 4020 Ulmer Rd, 220, Columbia, SC 29209-3305 | 2013-10-01 |
| Street Address |
15655 STATE ROUTE 170 STE H |
| City | CALCUTTA |
| State | OH |
| Zip Code | 43920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992321228 | Mary Matta | Podiatrist | 425 West Fith Street, East Liverpool, OH 43920 | 2020-06-23 |
| 1538795893 | Kaley M Davis | Occupational Therapist | 15655 Oh-170, East Liverpool, OH 43920 | 2020-03-19 |
| 1851890842 | Psycare Inc | Community/Behavioral Health | 15303 State Rout 170, East Liverpool, OH 43920 | 2018-02-06 |
| 1447760004 | Sarah Eileen Malcomson | Nurse Practitioner | 304 W 5th St, East Liverpool, OH 43920 | 2017-10-09 |
| 1427411438 | Help Hotline Crisis Center, Inc. | Community/Behavioral Health | 509 Market Street, East Liverpool, OH 43920 | 2016-03-29 |
| 1467848960 | Lorraine Barnard | Physical Therapy Assistant | 500 Self Ridge Street, Nentwick Convalescent Home, East Liverpool, OH 43920 | 2015-04-10 |
| 1891129441 | Jamie Jo Boyle | Nurse Practitioner | 425 West 5th Street, East Liverpool, OH 43920 | 2013-08-29 |
| 1275872038 | Tri-state Pediatric Associates, Inc | Pediatrics | 15700 State Street, Route 170, Calcutta, OH 43920 | 2013-02-13 |
| 1083953798 | Jill C Hendrickson | Psychologist | 416 Jackson Street, East Liverpool, OH 43920 | 2013-02-01 |
| 1104163468 | Laura Jane Plum | Occupational Therapy Assistant | 15675 Maple Drive, East Liverpool, OH 43920 | 2013-01-07 |
| Find all providers in zip 43920 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948667 | Grace Laszlo | Family Medicine | 2385 Creek View Pl, Grove City, OH 43123-1518 | 2020-09-29 |
| 1396350138 | Kelly Crego-lee | Family Medicine | 321 Neal Rd, Saint Paris, OH 43072-9305 | 2020-09-09 |
| 1669087524 | Deanna Tiffiene Thompson | Family Medicine | 895 Slagle Pl, Galloway, OH 43119-8821 | 2020-09-08 |
| 1982218145 | Kara Day | Family Medicine | 5867 Dantawood Ln, Liberty Twp, OH 45044-1309 | 2020-09-04 |
| 1669086260 | Family Care Plus Clinic LLC | Family Medicine | 4490 Darrow Rd, Stow, OH 44224-1885 | 2020-09-02 |
| 1619580693 | Erica Jayne Mack | Family Medicine | 542 W Mulberry St, Lancaster, OH 43130-2907 | 2020-08-28 |
| 1588277669 | Sarah Elizabeth Ruth Wilcox | Family Medicine | 3146 Grange Hill Pl, Dublin, OH 43017-1794 | 2020-08-28 |
| 1073126314 | Stawa Rajab Blanco | Family Medicine | 4900 Delhi Rd, Cincinnati, OH 45238-5345 | 2020-08-26 |
| 1154933463 | Amanda Taylor Greenrod | Family Medicine | 11010 Gabriella Dr, Parma, OH 44130-1468 | 2020-08-18 |
| 1457962110 | Mt. Eaton Medical Group | Family Medicine | 15988 E Chestnut St, Mt. Eaton, OH 44659 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
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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.