NICHOLAS DWAYNE JACKSON (NPI# 1528670916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528670916 |
| Entity Type | Individual |
| Full Name | NICHOLAS DWAYNE JACKSON |
| Credential | PHARMD |
| Practice Address |
201 Laurel Ave Coeburn VA 24293 |
| Mailing Address |
Po Box 1439 Coeburn VA 24230-1439 |
| Practice Telephone | 2768077106 |
| Practice Fax Number | 2768077341 |
| Mailing Telephone | 2768077106 |
| Mailing Fax Number | 2768077341 |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 0202208432 | VA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578977559 | Nicholas T Jackson | Chiropractor | 99 Regency Pkwy Ste 211, Mansfield, TX 76063-7819 | 2014-06-17 |
| 1356954440 | Nicholas Jackson | Health Educator | 2500 North State St., Preventive Medicine Department, Jackson, MS 39216 | 2020-08-28 |
| 1245857945 | Nicholas Christopher Jackson | Physical Therapist | 6710 108th Ave Ne, Kirkland, WA 98033 | 2020-06-29 |
| 1306476619 | Nicholas Jackson | Specialist/Technologist | 1325 Williams St, Adrian, MI 49221-2563 | 2020-01-26 |
| 1750828554 | Nicholas Jeffrey Jackson | Nurse Practitioner | 701 S Olive Ave, 407, West Palm Beach, FL 33401-6104 | 2017-01-31 |
| 1205298387 | Nicholas Jackson | Surgery | 800 Rose St # C-246, Division of General Surgery, Lexington, KY 40536-7001 | 2016-03-28 |
| 1750765467 | Nicholas Jackson | Pharmacist | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2015-07-13 |
| 1487052031 | Nicholas Jackson | Pharmacist | 941 Cherokee Dr Ste 1, Marshall, MO 65340-3646 | 2014-12-15 |
| 1538560651 | Nicholas Barclay Jackson | Student in an Organized Health Care Education/Training Program | 405 Central Ave, Northfield, IL 60093-3006 | 2014-09-08 |
| 1114234796 | Nicholas Jackson | Counselor | 2756 Post Rd, Warwick, RI 02886-3003 | 2010-09-03 |
| Street Address |
201 LAUREL AVE |
| City | COEBURN |
| State | VA |
| Zip Code | 24293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447736152 | Ttgi Corp | Pharmacy | 201 Laurel Ave, Coeburn, VA 24230 | 2018-07-16 |
| 1912518176 | Matthew Scott Villiard | Pharmacist | 201 Laurel Ave, Coeburn, VA 24230 | 2020-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104442367 | New Hope Addiction Recovery Inc | Family Medicine | 106 Spring Avenue Ne, Wise, VA 24293 | 2020-06-23 |
| 1225652340 | Jessica Wertz | Technician | 7507 Caddo Rd, Wise, VA 24293 | 2020-06-04 |
| 1831743632 | Ttgi2 LLC | Pharmacy | 426 West Main Street, Wise, VA 24293 | 2019-07-30 |
| 1861919730 | Mckenzie Grace Trotter | Speech-Language Pathologist | 324 School Ave Southeast, Wise, VA 24293 | 2017-08-23 |
| 1043734023 | 3 Guys Transport LLC | Non-emergency Medical Transport (VAN) | 5519 Pole Bridge Road, Wise, VA 24293 | 2017-08-01 |
| 1013352699 | Tester Chiropractic LLC. | Chiropractor | 411 East Main Street, Wise, VA 24293 | 2013-05-08 |
| 1861737181 | Family Preservation Services, Inc | Community/Behavioral Health | 5913 Airport Road, Wise, VA 24293 | 2012-11-28 |
| 1255614749 | Family Preservation Services, Inc | Community/Behavioral Health | 342 School Street, Wise, VA 24293 | 2011-09-21 |
| 1891013520 | Wise Rescue Squad Inc | Ambulance | 302 Railroad Ave, Wise, VA 24293 | 2010-05-05 |
| 1477784148 | Family Preservation Services, Inc. | Community/Behavioral Health | 117 Independence Avenue, Wise, VA 24293 | 2009-07-29 |
| Find all providers in zip 24293 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942509195 | Kimberly Dawn Evans | Pharmacist | 101 Laurel Ave, Coeburn, VA 24230-3529 | 2011-03-26 |
| 1952319014 | Jesse Littleton Zeigler IIi | Pharmacist | 501 Front St W, Marty Shopping Center, Coeburn, VA 24230-3607 | 2006-08-04 |
| 1912518176 | Matthew Scott Villiard | Pharmacist | 201 Laurel Ave, Coeburn, VA 24230 | 2020-08-12 |
| 1740570019 | Scarlett Ann Solomon | Pharmacist | 101 Laurel Ave, Coeburn, VA 24230-3529 | 2011-04-07 |
| 1578571634 | Amy Zeigler Bradley | Pharmacist | 501 Front St W, Marty Shopping Center, Coeburn, VA 24230-3607 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366254 | Mai Ngo | Pharmacist | 3768a Madison Ln, Falls Church, VA 22041-3678 | 2020-11-07 |
| 1619578358 | Mina Ekdawi | Pharmacist | 45735 Smoketree Ter, Sterling, VA 20166-7202 | 2020-11-07 |
| 1427659275 | Zachary Charles Woodley | Pharmacist | 151 Canterbury Ln, Winchester, VA 22603-4320 | 2020-11-06 |
| 1528669439 | Mary Nakbeen | Pharmacist | 41196 Canongate Dr, Leesburg, VA 20175-7072 | 2020-11-06 |
| 1336740174 | Golnaz Rezvani | Pharmacist | 1450 North Point Village Center, Reston, VA 20194 | 2020-11-06 |
| 1396346466 | Carl Nielsen | Pharmacist | 25050 Riding Plz, Chantilly, VA 20152-5925 | 2020-11-05 |
| 1598366460 | Gita Karimianpour | Pharmacist | 1070 Old Trail Dr, Crozet, VA 22932-3341 | 2020-11-05 |
| 1053912923 | Timothy Michael Nixon | Pharmacist | 61 Catoctin Circle, Leesburg, VA 20176 | 2020-11-05 |
| 1750982039 | Smita J Patel | Pharmacist | 43614 Millay Ct., Ashburn, VA 20147 | 2020-11-04 |
| 1669073888 | Chanju Shim | Pharmacist | 21000 Southbank St, Sterling, VA 20165-7242 | 2020-11-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on NICHOLAS DWAYNE 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.