DR. ALFRED JACKSON (NPI# 1609923028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609923028 |
| Entity Type | Individual |
| Full Name | DR. ALFRED JACKSON |
| Credential | MD |
| Practice Address |
15001 E Oxford Ave Aurora CO 80014-4186 |
| Practice Telephone | 3036931550 |
| Practice Fax Number | 3036938309 |
| Mailing Telephone | 3036931550 |
| Mailing Fax Number | 3036938309 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2012-08-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
21387 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 01213875 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164692224 | Alfred Manwuel Jackson | Dentist | 13527 Steelecroft Pkwy, Suite C, Charlotte, NC 28278-7545 | 2008-03-05 |
| 1750833414 | Alfred D. Jackson | Social Worker | 6200 Rockside Woods Blvd N Ste 305, Independence, OH 44131-2343 | 2016-10-28 |
| 1609189695 | Alfred Vaughn Derise Jackson Jr. | Emergency Medicine | 100 S Duncan St, Jamestown, TN 38556-3009 | 2010-07-19 |
| 1417078908 | Alfred B Jackson IIi | Physician Assistant | 501 W 14th St, Suite 4154, Wilmington, DE 19801-1013 | 2007-04-02 |
| Street Address |
15001 E OXFORD AVE |
| City | AURORA |
| State | CO |
| Zip Code | 80014-4186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407873342 | Excelsior Youth Centers, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2006-07-16 |
| 1518401967 | Chanelle N Pugh | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4191 | 2016-12-05 |
| 1679025951 | Rudy Balquin | Community Based Residential Treatment Facility, Mental Illness | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-11-02 |
| 1861946147 | Lisa Post | Residential Treatment Facility, Emotionally Disturbed Children | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-08-04 |
| 1790238152 | Serena Marie Marez Norell | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-08-02 |
| 1508319906 | Yesenia Arredondo | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-08-02 |
| 1669820593 | Cydney Horton | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-06-01 |
| 1437510906 | Nicole Termeer | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-03-11 |
| 1528428687 | Katie Lockley | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-03-02 |
| 1720448152 | Emily Dombrowski | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942825021 | Dieuvil Varice | Occupational Therapist | 2851 S Parker Rd Ste 570, Aurora, Co, Aurora, CO 80014 | 2020-06-14 |
| 1518437144 | Curtis E Redd | Case Manager/Care Coordinator | 1059 E Bethany Dr, Suite 200, Aurora, CO 80014 | 2018-11-27 |
| 1144795154 | Prestige Adult Day Care LLC | Clinic/Center | 2860 S Havana St, Unit C, Aurora, CO 80014 | 2018-10-05 |
| 1609375492 | Jacob Mcbride | Behavior Technician | 2121 S Blackhawk St 100, Aurora, CO 80014 | 2018-02-07 |
| 1265931240 | Jasmine Nicole Joseph | Behavior Technician | 2121 S. Blackhawk St., Aurora, CO 80014 | 2018-02-06 |
| 1255830238 | Russel Talukder | Behavioral Analyst | 2121 South Blackhawk St 100, Aurora, CO 80014 | 2018-02-06 |
| 1467951442 | Dylan Kelley | Behavior Technician | 2121 Blackhawk St. Suite 100, Aurora, CO 80014 | 2018-02-06 |
| 1184123168 | Talisa Fisher | Behavior Technician | 2121 S Blackhawk St Suite 100, Aurora, CO 80014 | 2018-02-06 |
| 1144732314 | Hellen A Noamesi | Registered Nurse | Kaiser Water Park 1, 2500 S. Havana St, Aurora, CO 80014 | 2017-10-27 |
| 1255840641 | Amanda Dawn Thompson | Massage Therapist | 3035 South Parker Rd., 560 Building E, Aurora, CO 80014 | 2017-09-28 |
| Find all providers in zip 80014 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023544277 | Paula Riggs | Psychiatry & Neurology | 12469 East 17th Place, Building 400, Aurora, CO 80045 | 2017-05-10 |
| 1750480398 | Katherine Lynn Keeton | Psychiatry & Neurology | 1291 S Potomac, Aurora, CO 80012 | 2006-09-21 |
| 1093245250 | Rebecca Iza Katz | Psychiatry & Neurology | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2017-06-19 |
| 1760914774 | Chloe L Yeung | Psychiatry & Neurology | 13123 E. 16th Avenue, Gary Pavilion 4th Floor, Aurora, CO 80045 | 2017-03-29 |
| 1578927273 | Jodi Zik | Psychiatry & Neurology | 13001 E 17th Pl, Aurora, CO 80045-2570 | 2016-04-08 |
| 1164819520 | Anastasia Klott | Psychiatry & Neurology | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2015-04-22 |
| 1598151508 | Jesse Hinckley | Psychiatry & Neurology | 13001 E 17th Pl, Aurora, CO 80045-2570 | 2015-04-07 |
| 1407241003 | Allison Nicole Hoff | Psychiatry & Neurology | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2015-03-31 |
| 1689092819 | Christopher Michael Piatz | Psychiatry & Neurology | 13001 E 17th Pl, Building 500 Mail Stop F546, Aurora, CO 80045-2570 | 2014-04-04 |
| 1386089134 | Eva Diaz | Psychiatry & Neurology | 13123 E 16th Ave, Aurora, CO 80045 | 2013-05-07 |
| Find all providers in AURORA | ||||
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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.