RONNIE L. JACKSON MD (NPI# 1659771350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659771350 |
| Entity Type | Organization |
| Organization Name | RONNIE L. JACKSON MD |
| Practice Address |
496 Northcrest Dr Springfield TN 37172-3972 |
| Practice Telephone | 6153821037 |
| Practice Fax Number | 6153820990 |
| Mailing Telephone | 6153821037 |
| Mailing Fax Number | 6153820990 |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2014-08-29 |
| Authorized Official Name | MR. RONNIE LEE JACKSON (OWNER) |
| Authorized Official Telephone | 6153821037 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MD020868 | TN | Other Service Providers |
| Street Address |
496 NORTHCREST DR |
| City | SPRINGFIELD |
| State | TN |
| Zip Code | 37172-3972 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447859376 | Results-ast Jv, LLC | Physical Therapist | 3556 Tom Austin Highway, Suite 2, Springfield, TN 37172 | 2020-10-21 |
| 1871107482 | Springfield Residential, LLC | Assisted Living Facility | 2530 South Main Street, Springfield, TN 37172 | 2020-09-01 |
| 1922610427 | Jenae Annette Rankin | Physical Therapist | Intelligent Therapy, 719 South Main Street, Springfield, TN 37172 | 2020-08-18 |
| 1043856297 | Jeffrey Brian Barnes | Pharmacist | 100 Northcrest Dr., Pharmacy, Springfield, TN 37172 | 2019-11-22 |
| 1407407968 | Sadie L Shields | Speech-Language Pathologist | Its 3131 Tom Austin Highway, Springfield, TN 37172 | 2019-09-26 |
| 1871148965 | Austin Chhut | Occupational Therapy Assistant | Intelligent Therapy Staffing, 3131 Tom Austin Hwy, Springfield, TN 37172 | 2019-08-06 |
| 1013409887 | Springfield Pediatric Dentistry | Dentist | 3130 Tom Austin Hwy Ste B, Springfield, TN 37172 | 2018-06-06 |
| 1083163752 | The Ridge | Counselor | 514 Hill Street, Springfield, TN 37172 | 2016-09-23 |
| 1902255516 | Dionna Marino | Case Manager/Care Coordinator | 731 Cheatham Street, Springfield, TN 37172 | 2016-06-06 |
| 1174964258 | Molly Williams | Registered Nurse | 800 S. Brown Street, Springfield, TN 37172 | 2013-07-17 |
| Find all providers in zip 37172 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1043666894 | Nina Olmeda | Specialist | 35 Braywood Cir, Springfield, MA 01151-1036 | 2016-05-11 |
| 1144681214 | Vickiejean Phillips | Specialist | 1332 35th St, Springfield, OR 97478-5554 | 2016-03-16 |
| 1811354681 | Monica M Jones | Specialist | 118 Victory Rd Apt 315, Springfield, NJ 07081-1342 | 2016-01-25 |
| 1215334941 | Brandon Avenue Pediatrics | Specialist | 6126 Brandon Ave, Springfield, VA 22150-2610 | 2014-11-24 |
| 1558766006 | Ozark Retina & Macula | Specialist | 1230 E Kingsley St Ste A, Springfield, MO 65804-7231 | 2014-10-27 |
| 1396146411 | Colin Bailey | Specialist | 155 S Tuttle Rd, Springfield, OH 45505-1560 | 2014-09-08 |
| 1659781136 | Ashley Foucha | Specialist | 1342 E Primrose St Ste A, Springfield, MO 65804-4224 | 2014-05-05 |
| 1225452881 | Elizabeth Creps | Specialist | 1623 21st St Ste B, Springfield, OR 97477-3417 | 2014-02-18 |
| 1649691098 | Kristin Seybold | Specialist | 1333 N 1st St, Springfield, OR 97477-3002 | 2014-01-01 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 37172 |
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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.