CAROL MACKENZIE JACKSON (NPI# 1457567265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457567265 |
| Entity Type | Individual |
| Full Name | CAROL MACKENZIE JACKSON |
| Credential | PA-C |
| Practice Address |
1331 E. Wyoming Avenue Cancer Treatment Centers of America/eastern Regional Me Philadelphia PA 19124 |
| Mailing Address |
1 Medical Center Blvd Acp #532 Chester PA 19013-3902 |
| Practice Telephone | 2155377542 |
| Practice Fax Number | 2155377884 |
| Mailing Telephone | 6104476288 |
| Mailing Fax Number | 6108762407 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2011-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MA052046 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538660741 | Carol Ann Jackson | Technician | 1310 Jackson Ave, Friona, TX 79035-1322 | 2018-02-22 |
| 1033533351 | Carol Wesslyn Jackson | Case Manager/Care Coordinator | 10150 Celia Berryhill Rd, Okmulgee, OK 74447-9013 | 2014-02-06 |
| 1376826693 | Carol A Jackson | Psychologist | 110 Paseo Del Canon W, Taos, NM 87571-6743 | 2011-09-22 |
| 1154601409 | Carol Frances Jackson | Case Manager/Care Coordinator | 3948 Mt. View Drive, Anchorage, AK 99508 | 2011-08-18 |
| 1801002720 | Carol Dashiell Jackson | Acupuncturist | 4100 Avenue G, Austin, TX 78751-4710 | 2007-05-15 |
| 1467420083 | Carol Diane Jackson | Nurse Practitioner | 712 First Terrace, #200, Lansing, KS 66043-1735 | 2006-03-09 |
| 1538164827 | Carol Jean Jackson | Physical Therapist | 100 N 1st St Ste 103, Step Ahead Physical Therapy, Burbank, CA 91502-1845 | 2005-06-14 |
| 1639674070 | Carol Jackson | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2018-03-28 |
| 1306287966 | Carol Anne Jackson | Behavioral Analyst | 1410 14th St, Plano, TX 75074-6302 | 2013-07-11 |
| 1003259029 | Carol Ann Jackson | Licensed Vocational Nurse | 592 Rio Lindo Ave, Chico, CA 95926-1817 | 2013-04-09 |
| Street Address |
1331 E. WYOMING AVENUE CANCER TREATMENT CENTERS OF AMERICA/EASTERN REGIONAL ME |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831749308 | William Mark Hanna Sr. | Pharmacist | 4600 Rooselvelt Blvd Bldg G, Philadelphia, PA 19124 | 2019-09-17 |
| 1881256451 | Medical Discovery Systems, LLC | Durable Medical Equipment & Medical Supplies | 5425 Oxford Ave., 5425 Oxford Ave. Suite (3 A), Philadelphia, PA 19124 | 2019-07-03 |
| 1548731391 | Sierra Pinkney | Registered Nurse | 1615 Granite St, Philadelphia, PA 19124 | 2018-12-05 |
| 1922507987 | Xavier Sergio Henriquez | Counselor | 4510 Frankford Avenue 2nd Floor, Philadelphia, PA 19124 | 2018-02-06 |
| 1558881581 | Isabel Cristina Castillo Hernandez | Pediatrics | 4500-10, Apt 201b, Philadelphia, PA 19124 | 2017-06-21 |
| 1952843732 | Patrick Grugan | Social Worker | Roosevelt Boulevard & Adams Avenue, Philadelphia, PA 19124 | 2016-11-10 |
| 1811340482 | Katarzyna Liwski | Psychiatry & Neurology | 4641 Roosevelt Boulevard, E212, Drexel University College of Medicine Friends Hospital, Philadelphia, PA 19124 | 2016-07-19 |
| 1851769327 | Aleka Kostouros | Social Worker | Roosevelt Blvd & Adams Ave, Northeast Community Center for Behavioral Health, Philadelphia, PA 19124 | 2015-09-14 |
| 1407230378 | Sara Bachani | Psychiatry & Neurology | 4641 Roosevelt Blvd, Friends Hospital, Room 231, Philadelphia, PA 19124 | 2015-07-10 |
| 1215327051 | Alyssa Renee Kirk | Counselor | 4500-10 Frankford Ave, 2nd Floor, Philadelphia, PA 19124 | 2015-02-02 |
| Find all providers in zip 19124 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283986 | Margaret Ann Malloy | Physician Assistant | 3223 N Broad St Fl 1, Philadelphia, PA 19140-5007 | 2020-10-20 |
| 1174122493 | Juliana Debnam | Physician Assistant | 235 S 15th St Apt 904, Philadelphia, PA 19102-5031 | 2020-10-19 |
| 1457950867 | Kyllington Spotts | Physician Assistant | 1151 N 3rd St Unit 301, Philadelphia, PA 19123-1578 | 2020-10-19 |
| 1598375925 | Meredith Jeanne Behr | Physician Assistant | 5401 N Broad St, Philadelphia, PA 19141 | 2020-07-31 |
| 1457977944 | Jiyean Yoo | Physician Assistant | 2929 Walnut St Apt 4424, Philadelphia, PA 19104-5096 | 2020-06-19 |
| 1356987747 | Jennifer Rose Cueni | Physician Assistant | 2120 Brandywine St, Philadelphia, PA 19130-3107 | 2019-11-21 |
| 1730740408 | Olivia Anne Leventry | Physician Assistant | 109 Fairmount Ave, Philadelphia, PA 19123-3004 | 2019-06-24 |
| 1588136055 | Jefferson University Physcians | Physician Assistant | 1020 Sansom St Fl 10, Philadelphia, PA 19107-5002 | 2018-12-21 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922589365 | Rachel Diane Simonsen | Physician Assistant | 1741 Frankford Ave Ste 100a, Philadelphia, PA 19125-2445 | 2018-08-23 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19124 |
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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.