MS. JACQUETTA JACKSON (NPI# 1659852440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659852440 |
| Entity Type | Individual |
| Full Name | MS. JACQUETTA JACKSON |
| Credential | LSA |
| Practice Address |
1021 Telluride Dr Arlington TX 76001-8529 |
| Mailing Address |
Po Box 938 Rowlett TX 75030-0938 |
| Practice Telephone | 2142272457 |
| Practice Fax Number | 2147640880 |
| Mailing Telephone | 2142272457 |
| Mailing Fax Number | 2147640880 |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2019-08-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
SA00703 | TX | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1021 TELLURIDE DR |
| City | ARLINGTON |
| State | TX |
| Zip Code | 76001-8529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770138851 | Jackson Elite Professionals, LLC | Specialist/Technologist, Other | 1021 Telluride Dr, Arlington, TX 76001-8529 | 2019-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255958229 | Patients Choice, LLC | Durable Medical Equipment & Medical Supplies | 719 W. Harris St., Suite B10, Arlington, TX 76001 | 2020-06-25 |
| 1396248688 | Holly Daniels | Health Educator | 7120 S. Cooper St., Arlington, TX 76001 | 2018-03-13 |
| 1629577036 | Samuel Kromer | Health Educator | 7120 S. Cooper Street, Arlington, TX 76001 | 2018-02-12 |
| 1578089678 | Lone Star Assist LLC | Specialist/Technologist, Other | 7802 Fox Chase Dr., Arlington, TX 76001 | 2017-08-21 |
| 1427595263 | Tayo Osiyemi | Behavior Technician | 6408 Rock Springs, Arlington, TX 76001 | 2017-01-31 |
| 1922555911 | Arlington-mansfield Area Young Men's Christian Association | Health Educator | 7201 S Cooper St, Arlington, TX 76001 | 2016-09-07 |
| 1356732267 | Jayce Rodriguez | Physician Assistant | 8015 S. Cooper Street, Arlington, TX 76001 | 2015-02-13 |
| 1194069849 | Kathryn Elise Johnson | Counselor | 7100 S Cooper St Ste 9, Arlington, TX 76001 | 2012-11-19 |
| 1831473305 | Jae Brimhall | Dentist | 6501 S Cooper St Ste 129, Arlington, TX 76001 | 2011-10-03 |
| 1114226990 | Resource Hcs & Txhml | Community/Behavioral Health | 7901 Modesto Dr, Arlington, TX 76001 | 2011-03-20 |
| Find all providers in zip 76001 | ||||
| Taxonomy Code | 246ZC0007X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Assistant |
| A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. |
| Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396380788 | Treva J Hiesermann | Specialist/Technologist, Other | 1203 Brookmont Dr, Arlington, TX 76018-2951 | 2019-11-09 |
| 1740772318 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 8402 Vinetree Dr, Arlington, TX 76002-4537 | 2018-05-30 |
| 1174025241 | Ahmad Sherzay | Specialist/Technologist, Other | 5218 Villa Del Mar Ave Apt 1416, Arlington, TX 76017-7516 | 2018-03-05 |
| 1629597372 | Se Sihongheune | Specialist/Technologist, Other | 7205 Fossil Garden Dr, Arlington, TX 76002-4445 | 2017-09-13 |
| 1578089678 | Lone Star Assist LLC | Specialist/Technologist, Other | 7802 Fox Chase Dr., Arlington, TX 76001 | 2017-08-21 |
| 1225563018 | Jimmie Davis Jr. | Specialist/Technologist, Other | 1109 Bell St, Arlington, TX 76001-7116 | 2017-04-28 |
| 1639434905 | Ernesto Cabrera | Specialist/Technologist, Other | 829 Hems Ln, Arlington, TX 76001-5920 | 2012-07-11 |
| 1902138506 | Jonathan Scott Wecker | Specialist/Technologist, Other | 8222 San Jose St, Arlington, TX 76002-3795 | 2010-02-05 |
| 1659548576 | Esteban Coss | Specialist/Technologist, Other | 3301 Matlock, Arlington, TX 76015 | 2008-05-09 |
| 1013516160 | Emily Abigail Lloyd | Specialist/Technologist, Other | 1715 N George Mason Dr Ste 504, Arlington, VA 22205-3670 | 2020-10-20 |
| Find all providers in ARLINGTON | ||||
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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.