BENNETT J JACKSON (NPI# 1568523157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568523157 |
| Entity Type | Individual |
| Full Name | BENNETT J JACKSON |
| Credential | ANP |
| Practice Address |
6307 Debarr Rd Ste C Anchorage AK 99504-1783 |
| Practice Telephone | 9073337425 |
| Practice Fax Number | 9073337719 |
| Mailing Telephone | 9073337425 |
| Mailing Fax Number | 9073337719 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 666 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | GROUP NPI | 1730113739 | 01 |
| AK | NP39831 | 05 |
| Street Address |
6307 DEBARR RD STE C |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99504-1783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689788184 | Faye Sai Duchanin | Physician Assistant | 6307 Debarr Rd Ste C, Patients First Medical Clinic, Anchorage, AK 99504-1783 | 2006-08-19 |
| 1326525155 | Isabel Vesely | Nurse Practitioner | 6307 Debarr Rd Ste C, Anchorage, AK 99504-1783 | 2018-07-24 |
| 1770775827 | Lisa M Jackson | Nurse Practitioner | 6307 Debarr Rd Ste C, Anchorage, AK 99504-1783 | 2007-08-13 |
| 1962575001 | Susan Lamb | Nurse Practitioner | 6307 Debarr Rd Ste C, Anchorage, AK 99504-1783 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962011593 | Deyoung Dentistry, LLC | Clinic/Center | 2601 Boniface Parkway Suite 1, Anchorage, AK 99504 | 2020-07-29 |
| 1881257475 | Tirzah Shelton | Psychologist | Veteran Affairs Clinic, 1201 North Muldoon, Anchorage, AK 99504 | 2019-04-18 |
| 1831651652 | Mekennah Ward | Massage Therapist | 7731 Northern Lights Blvd, #220, Anchorage, AK 99504 | 2019-04-01 |
| 1952883266 | Quality & Quantity Care Services LLC | Custodial Care Facility | 848 Elaine Dr, Anchorage, Ak, 99504, The Same, Anchorage, AK 99504 | 2018-09-04 |
| 1659858587 | Chloe Janelle Escalante | Psychologist | 511 Oaklahoma St., Apt 2, Anchorage, AK 99504 | 2018-07-24 |
| 1184100141 | Haa LLC | Durable Medical Equipment & Medical Supplies | 1409 Twining Dr, Anchorage, AK 99504 | 2018-07-12 |
| 1831626225 | Christian Wilfred, Thomas Garrett | Social Worker | 1201 N Mulddon Rd, Anchorage, AK 99504 | 2017-05-16 |
| 1609309954 | Rowena R Jones | Assisted Living Facility | 4009 Scenic View, Anchorage, AK 99504 | 2017-04-04 |
| 1982156733 | Agape Care Coordination LLC | Case Manager/Care Coordinator | 2050 Paxson Dr., Anchorage, AK 99504 | 2016-10-27 |
| 1649626169 | Pa Lou Vang | Registered Nurse | 7404 E 4th Ave Unit B, Anchorage, AK 99504 | 2016-05-13 |
| Find all providers in zip 99504 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760040711 | Wanatsanan Somkanay | Nurse Practitioner | 2211 E Northern Lights Blvd Ste 101, Anchorage, AK 99508-4192 | 2019-06-04 |
| 1700395951 | Nicole Zonzel | Nurse Practitioner | 3831 Piper St Sll 020, Anchorage, AK 99508 | 2017-09-20 |
| 1164944229 | Rona Janel Johnson | Nurse Practitioner | 3900 Ambassador Dr Fl 4, Anchorage, AK 99508-5922 | 2017-07-11 |
| 1255762837 | Kimberly D Kubick Anp LLC | Nurse Practitioner | 4821 Haru Ln, Anchorage, AK 99517-3283 | 2013-12-06 |
| 1235483512 | Family Sleep Clinics, LLC | Nurse Practitioner | 9170 Jewel Lake Rd, Ste 104, Anchorage, AK 99502-5381 | 2012-11-07 |
| 1710103924 | Nancy Jayne Zellmer | Nurse Practitioner | 3340 Providence Dr Ste 358, Anchorage, AK 99508-4627 | 2007-04-17 |
| 1033254826 | Shoshanah R Stone | Nurse Practitioner | 3300 Providence Dr Ste 304, Anchorage, AK 99508-4621 | 2007-02-20 |
| 1831271345 | Richard C Ervin | Nurse Practitioner | 1300 E 4th Ave, Anchorage, AK 99501-2815 | 2006-10-20 |
| 1639267768 | Ronald Robert Haggett | Nurse Practitioner | 2925 Debarr Rd., Suite 300, Anchorage, AK 99508 | 2006-10-11 |
| 1407940760 | J. Dette Avalon | Nurse Practitioner | 3524 East 15th Ave, Anchorage, AK 99508 | 2006-10-03 |
| Find all providers in ANCHORAGE | ||||
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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.