DR. TIMOTHY WILLIAM JACKSON (NPI# 1598997751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598997751 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY WILLIAM JACKSON |
| Credential | D.P.T. |
| Practice Address |
8918 Blakeney Professional Dr Suite 120 Charlotte NC 28277-6691 |
| Practice Telephone | 7049008960 |
| Mailing Telephone | 7049008960 |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251S0007X |
Physical Therapist Specialization: Sports |
2271 | NC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124338504 | Timothy Lawrence Jackson | Physician Assistant | 2722 N Mariah Way, Flagstaff, AZ 86004-7550 | 2010-10-19 |
| 1972610947 | Timothy Michael Jackson | Dentist | 982 Drayton Avenue, Elba, AL 36323 | 2006-08-24 |
| 1255444766 | Timothy K Jackson | Internal Medicine | 710 Genesis Blvd, Bridgeport, WV 26330-9668 | 2006-08-17 |
| 1982623625 | Timothy L Jackson | Physician Assistant | 5249 Providence Rd, Virginia Beach, VA 23464-4201 | 2006-07-19 |
| 1093710089 | Timothy D Jackson | Orthopaedic Surgery | 12080 New Orleans Ave N, Gulfport, MS 39503-3180 | 2005-06-16 |
| 1710473368 | Timothy Jackson | Registered Nurse | 1644 Central Ave, Mckinleyville, CA 95519-4342 | 2018-07-06 |
| 1336634641 | Timothy Jackson | Social Worker | 3820 Nine Mile Rd, Richmond, VA 23223-4831 | 2018-06-28 |
| 1538512520 | Timothy Jackson | Physical Therapist | 97 Gateway Business Park Dr, Ringgold, GA 30736-7395 | 2016-07-14 |
| 1538485396 | Timothy William Jackson | Counselor | 115 Liberty St, Bath, NY 14810-1508 | 2010-04-19 |
| 1679704001 | Timothy D Jackson | Surgery | Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 | 2009-08-03 |
| Street Address |
8918 BLAKENEY PROFESSIONAL DR SUITE 120 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277-6691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548244908 | Alan D Tyson | Physical Therapist | 8918 Blakeney Professional Dr, Suite 120, Charlotte, NC 28277-6691 | 2005-11-30 |
| 1871084392 | Christopher Cox | Physical Therapist | 8918 Blakeney Professional Dr, Charlotte, NC 28277-6691 | 2018-05-21 |
| 1124477971 | Chandler Page Thomas | Physical Therapist | 8918 Blakeney Professional Dr, Suite 120, Charlotte, NC 28277-6691 | 2016-06-11 |
| 1285010025 | Leon Knight | Physical Therapist | 8918 Blakeney Professional Dr, Suite 120, Charlotte, NC 28277-6691 | 2015-08-04 |
| 1679952709 | Candace Myers | Specialist/Technologist | 8918 Blakeney Professional Dr, Suite 120, Charlotte, NC 28277-6691 | 2015-05-21 |
| 1073878864 | Jessica Humbach Adamczak | Physical Therapist | 8918 Blakeney Professional Dr, Suite 120, Charlotte, NC 28277-6691 | 2012-07-09 |
| 1780834697 | Architech Sports and Physical Therapy, Inc. | Clinic/Center | 8918 Blakeney Professional Dr, Charlotte, NC 28277-6691 | 2008-09-27 |
| 1225288137 | Alicia B Tyson | Physical Therapist | 8918 Blakeney Professional Dr, Charlotte, NC 28277-6691 | 2008-09-27 |
| 1508940826 | George Alexander Betancourt | Dentist | 8918 Blakeney Professional Dr, Suite 100, Charlotte, NC 28277-6660 | 2006-10-24 |
| 1790873917 | John Michael Bovard | Chiropractor | 8918 Blakeney Professional Dr, Suite 110, Charlotte, NC 28277-6660 | 2006-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
| 1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
| 1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
| 1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
| Find all providers in zip 28277 | ||||
| Taxonomy Code | 2251S0007X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629499181 | Karon Williams | Physical Therapist | 5801 Rupert Ln, Charlotte, NC 28215-2347 | 2013-12-30 |
| 1871084392 | Christopher Cox | Physical Therapist | 8918 Blakeney Professional Dr, Charlotte, NC 28277-6691 | 2018-05-21 |
| 1093103970 | Pulse Sport Wear Inc | Physical Therapist | 818 Friendly Pl, Charlotte, NC 28213-5800 | 2014-12-31 |
| 1508075334 | Kenneth Joseph Corcoran | Physical Therapist | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1760923775 | Thomas Moore II | Physical Therapist | 5100 Paschall Dr, Durham, NC 27705-8534 | 2017-03-10 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1154730992 | Niles Fleet | Physical Therapist | Wingate Rd., Reynolds Gymnasium Room 106, Winston Salem, NC 27106 | 2014-08-06 |
| 1588940381 | James Edward Fernandes | Physical Therapist | Finch Yeager Building, Durham, NC 27710-0001 | 2011-10-25 |
| 1740466721 | Kyndall L Boyle | Physical Therapist | 719-a Greenway Rd #29, Suites 207 & 209, Boone, NC 28607 | 2008-01-21 |
| 1215135975 | Nicholas Daniel Potter | Physical Therapist | 118 Cameron Indoor Stadium, Box 90555, Durham, NC 27708-0001 | 2007-07-04 |
| 1356419360 | Carrie Ann Rubertino Shearer | Physical Therapist | 320 Emergency Room Dr, James A. Taylor Building Cb#7470, Chapel Hill, NC 27599-7470 | 2006-11-30 |
| 1942389861 | Todd Allen Watson | Physical Therapist | 1390 Sand Hill Rd, Suite 1, Candler, NC 28715-8938 | 2006-11-02 |
| 1285710145 | James Reece Scifers | Physical Therapist | 135 Moore Hall, Cullowhee, NC 28723 | 2006-10-31 |
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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.