DEREK JACKSON (NPI# 1659887180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659887180 |
| Entity Type | Individual |
| Full Name | DEREK JACKSON |
| Practice Address |
270 Carpenter Dr Ne Suite 400 Sandy Springs GA 30328 |
| Practice Telephone | 6784600345 |
| Practice Fax Number | 6784600350 |
| Mailing Telephone | 6784600345 |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356859326 | Derek Luther Jackson | Counselor | 581 Highway J North, Hayti, MO 63851 | 2018-01-12 |
| 1205298999 | Derek Cameron Jackson | Family Medicine | 1880 N Frontage Rd, Hastings, MN 55033-2687 | 2016-03-22 |
| 1225299357 | Derek Dean Jackson | Family Medicine | 777 N Raymond St, Boise, ID 83704-9251 | 2008-06-20 |
| 1811979123 | Derek C Jackson | Physician Assistant | 601 E Rollins St, Orlando, FL 32803-1248 | 2005-11-14 |
| Street Address |
270 CARPENTER DR NE SUITE 400 |
| City | SANDY SPRINGS |
| State | GA |
| Zip Code | 30328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275753782 | Family Ties Inc. | Community/Behavioral Health | 270 Carpenter Dr Ne, Suite 400, Sandy Springs, GA 30328-4931 | 2007-04-26 |
| 1598273724 | Kelmethia Busby | Social Worker | 270 Carpenter Dr Ne, Suite 400, Sandy Springs, GA 30328-0000 | 2018-01-23 |
| 1114352580 | Zareena Malone | Social Worker | 270 Carpenter Dr Ne, Suite 400, Sandy Springs, GA 30328-0000 | 2013-09-04 |
| 1437382066 | Amoritta Rochelle Butler | Chiropractor | 270 Carpenter Dr Ne, Suite 550, Sandy Springs, GA 30328-4931 | 2009-08-31 |
| 1871747683 | Bobby Edward Butler | Chiropractor | 270 Carpenter Dr Ne, Suite 550, Sandy Springs, GA 30328-4931 | 2008-11-06 |
| 1982801213 | Hugo T Mullins | Social Worker | 270 Carpenter Dr Ne, Suite 400, Sandy Springs, GA 30328-4931 | 2007-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467910042 | Amber Andrews | Behavior Technician | 750 Hammond Drive Bldg 7 Suite 100, Atlanta, GA 30328 | 2019-03-04 |
| 1215492830 | Ryan William Dubinin | Behavior Technician | 750 Hammond Drive, Building 7, Suite 100, Atlanta, NJ 30328 | 2019-02-07 |
| 1346710142 | Emily Rose Lloyd Swavely | Speech-Language Pathologist | 5825 Glenridge Rd., Building 1, Suite 133, Atlanta, GA 30328 | 2018-12-05 |
| 1063994481 | Mark Edward Brachmanski | Optometrist | 800 Mount Vernon Highway Ne, Suite 130, Atlanta, GA 30328 | 2018-09-01 |
| 1407352578 | Nina Brown | Massage Therapist | 7100 Peachtree Dunwoody Rd Ste 110, Sandy Springs, GA 30328 | 2018-04-05 |
| 1336657741 | Renee Usher Reeves | Assistant Behavior Analyst | 750 Hammond Dr Building 7, Suite 100, Atlanta, GA 30328 | 2018-01-19 |
| 1487168274 | Patricia Nicole Felder | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr, Ne, Suite # 400, Atlanta, GA 30328 | 2017-12-01 |
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1770093601 | Syed M Rasheed | Physician Assistant | 5788 Roswell Rd Ste 100, Atlanta, GA 30328 | 2017-10-05 |
| 1437678190 | Jeanette Denise Jones | Counselor | 270 Carpenter Drive, Suite 400, Sandy Springs, GA 30328 | 2017-09-13 |
| Find all providers in zip 30328 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508385758 | Sharen Ann Torrence | Student in an Organized Health Care Education/Training Program | 270 Carpenter Drive Ne, 400, Sandy Springs, GA 30328-3032 | 2017-09-19 |
| 1417296443 | Simone Austin | Student in an Organized Health Care Education/Training Program | 522 Granville Ct Ne, Sandy Springs, GA 30328-3440 | 2013-02-12 |
| 1194347641 | Paul Kim | Student in an Organized Health Care Education/Training Program | 6649 Encore Blvd, Sandy Springs, GA 30328-2889 | 2020-05-07 |
| 1518437490 | Zachariah Chanet | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr Ste 400, Sandy Springs, GA 30328-4933 | 2018-12-04 |
| 1073088118 | Sandra Fay Kelly Calloway | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr Ste 400, Sandy Springs, GA 30328-4933 | 2018-10-04 |
| 1750864278 | Edward Senior V | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr Ste 400, Sandy Springs, GA 30328-4933 | 2018-09-11 |
| 1073096699 | Chelsie Hart | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr Ste 400, Sandy Springs, GA 30328-4933 | 2018-09-10 |
| 1912487737 | Roselyn Almonte | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr, Sandy Springs, GA 30328-4931 | 2018-08-21 |
| 1740760388 | Chamaco Lawan Bryant | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr Ste 400, Sandy Springs, GA 30328-4933 | 2018-08-14 |
| 1992298327 | Jamilla Isom-sakers | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr, Sandy Springs, GA 30328 | 2018-06-11 |
| Find all providers in SANDY SPRINGS | ||||
| City | SANDY SPRINGS |
| Zip Code | 30328 |
Please comment or provide details below to improve the information on DEREK JACKSON.
| 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.