R. BRUCE JACKSON II, M.D., P.A. (NPI# 1619064573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619064573 |
| Entity Type | Organization |
| Organization Name | R. BRUCE JACKSON II, M.D., P.A. |
| Practice Address |
222 Longvue Dr Boone NC 28607-5060 |
| Practice Telephone | 8282629696 |
| Practice Fax Number | 8282652306 |
| Mailing Telephone | 8282629696 |
| Mailing Fax Number | 8282652306 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ROBERT BRUCE JACKSON I (DOCTOR) |
| Authorized Official Telephone | 8282629696 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 24975 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
222 LONGVUE DR |
| City | BOONE |
| State | NC |
| Zip Code | 28607-5060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391809 | Deanna Renee Reary | Nurse Practitioner | 222 Longvue Dr, Boone, NC 28607-5060 | 2019-11-20 |
| 1497151500 | Tiffany Lynn Shreve | Nurse Practitioner | 222 Longvue Dr, Boone, NC 28607-5060 | 2014-11-17 |
| 1265669535 | Mountain Laurel Family Practice, Pllc | Nurse Practitioner | 222 Longvue Dr, Boone, NC 28607-5060 | 2009-06-15 |
| 1346324159 | Leanne Young-fritchie | Nurse Practitioner | 222 Longvue Dr, Boone, NC 28607-5060 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184261232 | Blaire E. Warren, Dds, Pllc | Clinic/Center | 142 Doctors Drive, Boone, NC 28607 | 2019-12-09 |
| 1073176871 | Whitney B Van Sant | Psychologist | 719-a Greenway Rd., Boone, NC 28607 | 2019-04-17 |
| 1710489273 | Appalachian Regional Medical Associates Inc | Internal Medicine | Appgastro - Asc, 870 State Farm Rd, Ste 102, Boone, NC 28607 | 2018-03-01 |
| 1891234019 | Laura Kacere | Counselor | 895 State Farm Rd Ste 507-5, Boone, NC 28607 | 2017-02-21 |
| 1902357320 | Innate Chiropractic - Pllc | Chiropractor | 838 State Farm Road, Ste 1, Boone, NC 28607 | 2016-10-20 |
| 1437519501 | David Hale Johnson | Nurse Practitioner | 169 Doctors Drive, Boone, NC 28607 | 2016-03-02 |
| 1639538895 | Lara Mele | Lactation Consultant, Non-RN | 180 Pine Hill Road, Boone, NC 28607 | 2016-02-16 |
| 1659749927 | Rachel Arledge | Counselor | 895 State Farm Rd. Bldg. 500, Ste. 505, Boone, NC 28607 | 2015-09-03 |
| 1346625431 | Kelly Walsh Whiteley | Dentist | 450 New Market Blvd Ste 2, Boone, NC 28607 | 2015-07-30 |
| 1184000234 | Ruby Amanda Stipe Blaylock | Physician Assistant | 2146 Blowing Rock Road - App Urgent Care, Boone, NC 28607 | 2015-07-30 |
| Find all providers in zip 28607 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558375733 | John J. Freeman | Obstetrics & Gynecology | 838 State Farm Rd., Su:2, Boone, NC 28607-5391 | 2006-07-27 |
| 1902884562 | Cecilia Fabry Grasinger | Obstetrics & Gynecology | 381 Deerfield Rd, Boone, NC 28607-5009 | 2006-01-04 |
| 1427444397 | Courtney Damian | Obstetrics & Gynecology | 381 Deerfield Rd, Boone, NC 28607-5009 | 2015-04-07 |
| 1033434527 | Kristen Taylor Bracy | Obstetrics & Gynecology | 801 Bamboo Rd, Boone, NC 28607-8721 | 2010-03-29 |
| 1316184807 | Appalachian Regional Medical Associates | Obstetrics & Gynecology | 169 Doctors Dr, Boone, NC 28607-5017 | 2009-01-21 |
| 1083851539 | Appalachian Regional Medical Associates | Obstetrics & Gynecology | 166 Doctors Dr, Boone, NC 28607-5000 | 2009-01-20 |
| 1780885897 | Susan Almquist | Obstetrics & Gynecology | 381 Deerfield Rd, Boone, NC 28607-5009 | 2007-05-29 |
| 1245305713 | Beverly Fortner Womack | Obstetrics & Gynecology | 381 Deerfield Rd, Boone, NC 28607-5009 | 2006-11-21 |
| 1316982200 | Boone County Comprehensive Specialty Care | Obstetrics & Gynecology | 1015 Union St, Suite 120, Boone, IA 50036-4821 | 2006-06-17 |
| 1922050855 | Lynda Gioia-flynt | Obstetrics & Gynecology | 381 Deerfield Rd, Boone, NC 28607-5009 | 2006-05-17 |
| Find all providers in BOONE | ||||
Please comment or provide details below to improve the information on R. BRUCE JACKSON II, M.D., P.A..
| 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.