MS. SUSAN ELAINE JACKSON (NPI# 1649557208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649557208 |
| Entity Type | Individual |
| Full Name | MS. SUSAN ELAINE JACKSON |
| Credential | RPA-C |
| Practice Address |
12 Leach Rd Lyons NY 14489-9732 |
| Practice Telephone | 3159466075 |
| Mailing Telephone | 3159466075 |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2011-11-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
015280 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407316003 | Susan Jackson | Pharmacist | 1022 Sealyham Ct, Reynoldsburg, OH 43068-4763 | 2019-03-21 |
| 1831624113 | Susan Jackson | Speech-Language Pathologist | 616 W Virginia Ave, Sebring, OH 44672-1142 | 2017-04-25 |
| 1487064986 | Susan Jackson | Social Worker | 425 W 48th St, 4k, New York, NY 10036 | 2014-05-06 |
| 1538476601 | Susan Jackson | Pharmacist | 5540 S 900 E, Salt Lake City, UT 84117-7206 | 2010-09-09 |
| 1609042639 | Susan Jackson | Physical Therapist | 3275 Soft Breeze Cir, West Melbourne, FL 32904-7710 | 2008-04-30 |
| 1073781613 | Susan Jean Jackson | Physical Therapist | 901 W 9th St Apt 414, Austin, TX 78703-4629 | 2008-02-18 |
| 1699951368 | Susan Elizabeth Jackson | Nurse Practitioner | 20 Mair Ave, Totowa, NJ 07512-2313 | 2008-01-12 |
| 1780749671 | Susan Marie Jackson | Family Medicine | 25066 Sr 11, Hallstead, PA 18822 | 2006-12-22 |
| 1871048520 | Susan Marie Jackson | Case Manager/Care Coordinator | 1125 W 6th St, Los Angeles, CA 90017-1833 | 2016-08-23 |
| 1760835300 | Susan H Jackson | Marriage & Family Therapist | 8350 Archibald Ave Ste 125, Rancho Cucamonga, CA 91730-7701 | 2016-07-19 |
| Street Address |
12 LEACH RD |
| City | LYONS |
| State | NY |
| Zip Code | 14489-9732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992784169 | Alberto Beltrano | Surgery | 12 Leach Rd, Lyons, NY 14489-9732 | 2006-01-16 |
| 1518049865 | Marino D Tavarez | Family Medicine | 12 Leach Rd, Lyons Health Center, Lyons, NY 14489-9732 | 2006-10-19 |
| 1093727612 | Dong Gi Hong | Internal Medicine | 12 Leach Rd, Lyons, NY 14489-9732 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730645623 | Tracy Merlau | Social Worker | Wbhn, 1519 Nye Road, Suite 110, Lyons, NY 14489 | 2019-02-15 |
| 1871069005 | Mary P. Hutchings | Licensed Practical Nurse | 1489 Jackson Road, Lyons, NY 14489 | 2018-10-15 |
| 1235501529 | Connie Sue Fuller | Registered Nurse | 2104 Maple Street Rd, Lyons, NY 14489 | 2015-10-26 |
| 1033480645 | Kathleen R Hayes | Registered Nurse | 10 Clyde Rd., Lyons, NY 14489 | 2012-01-13 |
| 1871878751 | Amy H Smith | Psychologist | 1519 Nye Raod, Lyons, NY 14489 | 2011-10-11 |
| 1588996169 | Faith Erica Mcdonald | Licensed Practical Nurse | 12 Jacksn St, Apt 2, Lyons, NY 14489 | 2010-02-05 |
| 1255463261 | Nicole Jennifer Yager | Counselor | Wayne Behavioral Heatlh Network, 1519 Nye Road, Lyons, NY 14489 | 2007-03-12 |
| 1154466639 | Debra Lee Woodworth Fiori | Counselor | Wayne Behavioral Health Netowork, 1519 Nye Road, Lyons, NY 14489 | 2007-02-21 |
| 1124163829 | Joan M Kovachi | Registered Nurse | Wayne Behavioral Health Network, 1519 Nye Road, Lyons, NY 14489 | 2007-02-20 |
| 1306932645 | Kimberly F Mccaffrey | Speech-Language Pathologist | 159 Montezuma Street, Lyons, NY 14489 | 2006-10-05 |
| Find all providers in zip 14489 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194829796 | Sandra Dooley | Physician Assistant | 151 Knollcroft Rd, Lyons, NJ 07939-5001 | 2006-09-12 |
| 1679689004 | Peter J. Thiele | Physician Assistant | 220 Main St, Lyons, NE 68038-2676 | 2006-08-21 |
| 1023028644 | Andrea Dean | Physician Assistant | 151 Knollcroft Road, Lyons, NJ 07939 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487252581 | North Shore Medical Group Pllc | Physician Assistant | 311 Skyview Ter, Syracuse, NY 13219-2835 | 2020-10-12 |
| 1477169654 | Kristen Ariel O'connell | Physician Assistant | 85 John St Apt 7a, New York, NY 10038-2844 | 2020-09-22 |
| 1699381616 | David Nmn Kao | Physician Assistant | 737 Pleasant Avenue, Westbury, NY 11590-6407 | 2020-09-16 |
| 1043824816 | Elizabeth Keane | Physician Assistant | 25 Hollis Dr, Sound Beach, NY 11789-1629 | 2020-08-31 |
| 1497364111 | Tianna Stephens | Physician Assistant | 165 N Village Ave Ste 5, Rockville Centre, NY 11570-3701 | 2020-07-28 |
| 1124636188 | Shannon Maureen O'connell | Physician Assistant | 270-05 270th Ave, New Hyde Park, NY 11040 | 2020-07-16 |
| 1841818895 | Yanick Dugue | Physician Assistant | 4 Lincoln Ave, New Hyde Park, NY 11040-3125 | 2020-07-07 |
| 1194340505 | Kayleigh Marie Tourt | Physician Assistant | 222 Alexander St Fl 4, Rochester, NY 14607-4039 | 2020-06-11 |
| 1023638509 | Kristina Rajic | Physician Assistant | 7237 66th Dr, Flushing, NY 11379-2111 | 2020-04-24 |
| 1114547791 | Michele Hein | Physician Assistant | 700 Veterans Memorial Hwy, Hauppauge, NY 11788-2952 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
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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.