MR. JERROLD J JACKSON (NPI# 1457591455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457591455 |
| Entity Type | Individual |
| Full Name | MR. JERROLD J JACKSON |
| Credential | SLP |
| Practice Address |
1231 Greenway Dr Ste 100 Irving TX 75038 |
| Mailing Address |
728 Bray St Cedar Hill TX 75104-6058 |
| Practice Telephone | 9728711800 |
| Mailing Telephone | 9728021176 |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2018-07-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 107746 | TX | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 40-4702665 | 05 | |
| MI | UNITED HEALTHCARE INSURANCE | 46-31868 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 Oakland Dr Fl 3, Kalamazoo, MI 490081282 | 2693877004 | 2693877026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598021081 | Jerrold Jackson | Counselor | 10216 Beacon Ave S, Tukwila, WA 98178-2039 | 2012-04-09 |
| 1659530053 | Jerrold Jackson | Social Worker | One Gustave L Levy Place, Box 1230 - Mount Sinai Hospital, New York, NY 10029-6574 | 2008-06-02 |
| Street Address |
1231 GREENWAY DR STE 100 |
| City | IRVING |
| State | TX |
| Zip Code | 75038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124682976 | Lauren Mcgrady | Speech-Language Pathologist | 1231 Greenway Dr Ste 100, Irving, TX 75038-2525 | 2019-04-26 |
| 1366005639 | Catherine M Henderson | Occupational Therapist | 1231 Greenway Dr Ste 100, Irving, TX 75038-2525 | 2019-04-22 |
| 1679035596 | Priyanka Gianchandani | Physical Therapist | 1231 Greenway Dr Ste 100, Irving, TX 75038-2525 | 2019-04-01 |
| 1003372129 | Ebony Danielle Hartfield | Specialist/Technologist | 1231 Greenway Dr Ste 100, Irving, TX 75038-2525 | 2019-02-13 |
| 1356815450 | Shankesha Seay | Specialist/Technologist | 1231 Greenway Dr Ste 100, Irving, TX 75038-2525 | 2019-01-11 |
| 1518437003 | Dacia Bell | Specialist/Technologist | 1231 Greenway Dr Ste 100, Irving, TX 75038-2525 | 2018-11-28 |
| 1740756469 | Phoebe Corinne Lopez | Speech-Language Pathologist | 1231 Greenway Dr Ste 100, Irving, TX 75038-2525 | 2018-10-19 |
| 1871072504 | Caitlyn Rose Wenner | Speech-Language Pathologist | 1231 Greenway Dr Ste 100, Irving, TX 75038-2525 | 2018-08-13 |
| 1093292955 | Anna Leigh Cargile | Speech-Language Pathologist | 1231 Greenway Dr Ste 100, Irving, TX 75038-2525 | 2018-07-24 |
| 1366929333 | Kaitlyn Nolan | Speech-Language Pathologist | 1231 Greenway Dr Ste 100, Irving, TX 75038 | 2018-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457959587 | S&w Primary Home Care | Home Health | 3921 Timberidge Drive, Irving, TX 75038 | 2020-10-12 |
| 1295372928 | Wecare Tlc | Clinic/Center | 777 Hidden Ridge, Irving, TX 75038 | 2019-12-02 |
| 1407369135 | North Texas Psychiatry Associates Pllc | Psychiatry & Neurology | 4020 N. Macarthur Blvd, Suite 122 - 153, Irving, TX 75038 | 2017-11-16 |
| 1164970745 | Young Men's Christian Association of Metropolitan Dallas | Health Educator | 1621 W Walnut Hill Ln, Irving, TX 75038 | 2016-09-13 |
| 1285086397 | Edge-md Holding Pllc | Family Medicine | 1200 W. Walnut Hill Lane, Suite 3950, Irving, TX 75038 | 2016-07-13 |
| 1912318445 | Alliance Neurodiagnostics, LLC | Clinic/Center | 4545 Fuller Dr Ste 200, Irving, TX 75038 | 2014-05-19 |
| 1790029841 | Paul Dean Allen | Counselor | 5525 N. Macarthur Blvd, Suite 800, Mhn Government Services, Irving, TX 75038 | 2012-11-15 |
| 1437403227 | Dashwood Pharmacy | Pharmacy | 1300 W. Walnut Hill Lane, Suite 163, Irving, TX 75038 | 2012-11-01 |
| 1265795538 | Michael Fooshee | Dentist | 3007 Skyway Circle North, Suite 100, Irving, TX 75038 | 2012-06-20 |
| 1205107273 | Sylviane Akenda Kasende | Nurse Practitioner | 2925 Skyway Circle N, Irving, TX 75038 | 2012-01-23 |
| Find all providers in zip 75038 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528520418 | Joshua Henfey | Speech-Language Pathologist | 6908 Parkridge Blvd Apt 130, Irving, TX 75063-9103 | 2019-04-01 |
| 1578043329 | Sunitha Nambiar | Speech-Language Pathologist | 3443 N Macarthur Blvd, Irving, TX 75062-4411 | 2018-08-20 |
| 1114264686 | Nina Sophia Lara | Speech-Language Pathologist | 10549 N Macarthur Blvd Apt 2106, Irving, TX 75063-7778 | 2013-01-03 |
| 1568719235 | Veronica Bridgeforth | Speech-Language Pathologist | 4500 Fuller Dr, Irving, TX 75038-6529 | 2012-08-12 |
| 1982950176 | Nipa Raval | Speech-Language Pathologist | 8855 Valley Ranch Parkway, Irving, TX 75063 | 2012-07-25 |
| 1962782045 | Chandler B. Ude | Speech-Language Pathologist | 508 Gilbert Rd, Irving, TX 75061-6239 | 2011-08-22 |
| 1740579705 | Meredith Peyton | Speech-Language Pathologist | 4821 N O Connor Rd, 346, Irving, TX 75062-2254 | 2011-03-30 |
| 1336456813 | Mary Louise Bongfeldt | Speech-Language Pathologist | 1533 Atlanta Dr, Irving, TX 75062-5302 | 2010-09-07 |
| 1639480155 | Natalie Anne Hobbs | Speech-Language Pathologist | 845 Rts 5 & 20, Irving, NY 14081-9706 | 2010-06-30 |
| 1528396389 | Mark James Ashley | Speech-Language Pathologist | 1320 W Walnut Hill Ln, Irving, TX 75038-3007 | 2009-12-05 |
| Find all providers in IRVING | ||||
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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.