RANDOLPH THOMAS JACKSON (NPI# 1457310518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1457310518 |
Entity Type | Individual |
Full Name | RANDOLPH THOMAS JACKSON |
Credential | M.D. |
Practice Address |
11010 Haskell Ave Kansas City KS 66109-8500 |
Mailing Address |
4801 S Cliff Ave Suite 100 Independence MO 64055-7015 |
Practice Telephone | 8164781230 |
Practice Fax Number | 8163504166 |
Mailing Telephone | 8163504536 |
Mailing Fax Number | 8163504585 |
Enumeration Date | 2006-03-18 |
Last Update Date | 2009-05-07 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207W00000X | Ophthalmology | 2006012805 | MO | Allopathic & Osteopathic Physicians |
Y | 207W00000X | Ophthalmology | 31896 | KS | Allopathic & Osteopathic Physicians |
N | 207W00000X | Ophthalmology | 10506 | MT | Allopathic & Osteopathic Physicians |
N | 207W00000X | Ophthalmology | 46566 | MN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KS | RAILROAD MEDICARE | P00685107 | 01 |
Street Address |
11010 HASKELL AVE |
City | KANSAS CITY |
State | KS |
Zip Code | 66109-8500 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346489747 | Eye Care, Pa | Eyewear Supplier (Equipment, not the service) | 11010 Haskell Ave, Kansas City, KS 66109-8500 | 2009-02-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154796688 | Lance Miller | Pharmacist | 10510 Parallel, Kansas City, KS 66109 | 2015-12-09 |
1386016293 | Tara Newton | Community Health Worker | 2821 N 91 St, Kansas City, KS 66109 | 2015-10-30 |
1952726473 | Dia L Herr | Clinic/Center | 2617 N. 69th Street, Kansas City, KS 66109 | 2014-02-20 |
1033559570 | Legends Dental Group, P.a. | Dentist | 10818 Parallel Parkway, Kansas City, KS 66109 | 2013-06-28 |
1215277694 | Kristin Kathleen Porter | Dietitian, Registered | 10124 Hutton Road, Kansas City, KS 66109 | 2013-02-22 |
1932459229 | Sams West, Inc | Technician/Technologist | 10510 Parrallel Pkwy, Kansas City, KS 66109 | 2012-09-13 |
1356642276 | Anjali Doshi | Dentist | 10818 Parallel Pkwy, Kansas City, KS 66109 | 2010-11-09 |
1841411675 | Wendy Ann Brakhage | Chiropractor | 2300 Hutton Road, Suite 101, Kansas City, KS 66109 | 2007-05-01 |
1205953742 | Lisa R Gonzales | Dentist | 10203 Leavenworth Road, Kansas City, KS 66109 | 2007-03-22 |
1497898290 | Shannon R Margherio | Physical Therapist | 1801 N 98th Street, Kansas City, KS 66109 | 2007-02-14 |
Find all providers in zip 66109 |
Taxonomy Code | 207W00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Ophthalmology |
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003466897 | Mcelhinney Eye Care, Pa | Ophthalmology | 1004 Carondelet Dr Ste 405, Kansas City, MO 64114-4801 | 2019-09-13 |
1003250606 | Manuel David Camejo | Ophthalmology | 4320 Wornall Rd Ste 220, Kansas City, MO 64111-5954 | 2013-04-25 |
1235366139 | Allen G Parelman | Ophthalmology | 402 W 50th St, Kansas City, MO 64112-2528 | 2009-06-17 |
1407929417 | Tauber Eye Center LLC | Ophthalmology | 4400 Broadway St Ste 202, Kansas City, MO 64111-3342 | 2006-11-16 |
1265532642 | Jerry William Cook | Ophthalmology | 7400 Nw Whipple Ln, Kansas City, MO 64152-1856 | 2006-09-25 |
1356357230 | Gurinder Singh | Ophthalmology | 155 South 18th Street, Suite 220, Kansas City, KS 66102 | 2006-07-31 |
1144265075 | Perfect Sense Eye Center PC | Ophthalmology | 211 Ne 54th, Ste 202, Kansas City, MO 64118-4337 | 2006-06-17 |
1447204441 | Amy E Ciccio | Ophthalmology | 7701 State Line Rd, Kansas City, MO 64114-1635 | 2006-05-22 |
1245207398 | Louis Monaco II | Ophthalmology | 2301 Holmes, Kansas City, MO 64018-1192 | 2006-03-07 |
1174525208 | Karl D Hendricks | Ophthalmology | 8919 Parallel Pkwy, Ste 226, Kansas City, KS 66112-1655 | 2005-06-01 |
Find all providers in KANSAS CITY |
City | KANSAS CITY |
Zip Code | 66109 |
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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.