DR. MALAKA BAHARAH JACKSON (NPI# 1609806264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609806264 |
| Entity Type | Individual |
| Full Name | DR. MALAKA BAHARAH JACKSON |
| Credential | M.D. |
| Practice Address |
201 Queens Rd Charlotte NC 28204-3217 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043165285 |
| Mailing Telephone | 7043847834 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
2017-01294 | NC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 330 Billingsley Rd Ste 101, Charlotte, NC 282115020 | 7043162335 | |
| 9 Medical Park Rd, Suite 230, Columbia, SC 292038003 | 8034347956 | 8034348606 |
| Street Address |
201 QUEENS RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28204-3217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083663454 | Larry Jason Byrd | Nurse Practitioner | 201 Queens Rd, Charlotte, NC 28204-3217 | 2006-05-10 |
| 1134765126 | Novant Medical Group, Inc. | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2019-11-25 |
| 1093376642 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2019-06-25 |
| 1568027001 | Novant Medical Group, Inc. | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2019-05-09 |
| 1417433947 | Shelly Spoerre | Dietitian, Registered | 201 Queens Rd, Charlotte, NC 28204-3217 | 2018-07-18 |
| 1205320306 | Novant Medical Group, Inc. | Pediatrics | 201 Queens Rd, Charlotte, NC 28204 | 2018-06-21 |
| 1639695133 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204 | 2017-08-16 |
| 1417477977 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2017-06-26 |
| 1386164051 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2017-06-23 |
| 1386173581 | Jonathan Mercer Foell | Specialist/Technologist | 201 Queens Rd, Charlotte, NC 28204 | 2017-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285263582 | Precise Home Care Service LLC | In Home Supportive Care | 1935 Baxter Street, Unit 101, Charlotte, NC 28204 | 2020-04-07 |
| 1285276253 | Shannon Miller | Counselor | 1432 E Seventh Street, Charlotte, NC 28204 | 2019-10-11 |
| 1194282202 | Madison Joann Mcgarrigle | Behavior Technician | 1401 East 7th Street, Charlotte, NC 28204 | 2019-02-25 |
| 1255802674 | Stacey D. Alston, Dds, Pa | Dentist | 1020 E. 10th St., Suite 1, Charlotte, NC 28204 | 2018-12-11 |
| 1972082097 | Kim Webb Talbert | Nurse Practitioner | Novant Health Presbyterian Medical Center Charlotte, 200 Hawthorne Lane, Charlotte, NC 28204 | 2018-08-09 |
| 1164910535 | Jesse Elijah Roberts | Counselor | 1801 E 5th Street, #208, Charlotte, NC 28204 | 2018-05-01 |
| 1336696848 | Eight Healthcare | Exclusive Provider Organization | 2455 Weddington Ave, 2110, Charlotte, NC 28204 | 2016-09-01 |
| 1225480551 | Kathleen Quintana Bradley | Physician Assistant | 1523 Elizabeth Ave., Suite 200, Charlotte, NC 28204 | 2016-07-11 |
| 1184049777 | Della Franklin | Speech-Language Pathologist | 1021 Morehead Medical Dr Ste 3300, Charlotte, NC 28204 | 2014-02-19 |
| 1225459845 | Healing Arts Medical, Pa | Family Medicine | 335 N. Caswell Rd., Charlotte, NC 28204 | 2013-12-27 |
| Find all providers in zip 28204 | ||||
| Taxonomy Code | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801825914 | Lisa Houchin | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2006-07-01 |
| 1386164051 | Novant Medical Group, Inc | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2017-06-23 |
| 1700213113 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 101 E Wt Harris Blvd, Bldg 3000 Ste 3301c, Charlotte, NC 28262-3485 | 2013-09-30 |
| 1962778266 | Diana Elizabeth Miller | Pediatrics | 201 Queens Rd, Charlotte, NC 28204-3217 | 2012-03-30 |
| 1962797654 | Carolinas Medical Center-northeast | Pediatrics | 101 E W T Harris Blvd, Bldg 3000, Suite 3301c, Charlotte, NC 28262-7000 | 2011-06-10 |
| 1053605873 | Elizabeth Dabrowski | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2011-06-09 |
| 1184811937 | Jakub Mieszczak | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2007-09-26 |
| 1679582134 | Pediatric Endocrinology & Diabetes Specialists | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2006-08-05 |
| 1740212901 | Mark Vanderwel | Pediatrics | 4501 Cameron Valley Pkwy, Ste 200, Charlotte, NC 28211-4297 | 2006-07-07 |
| 1912937475 | Mark Parker | Pediatrics | 4501 Cameron Valley Pkwy, Suite 200, Charlotte, NC 28211-4297 | 2006-07-03 |
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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.