DR. BRADLEY KENT JACKSON (NPI# 1699217778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1699217778 |
Entity Type | Individual |
Full Name | DR. BRADLEY KENT JACKSON |
Credential | PHD |
Practice Address |
13123 E 16th Ave # 245 Aurora CO 80045-7106 |
Practice Telephone | 7207776662 |
Practice Fax Number | 7207777270 |
Mailing Telephone | 7207776662 |
Mailing Fax Number | 7207777270 |
Enumeration Date | 2016-11-07 |
Last Update Date | 2016-11-07 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
2536 | CO | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124206487 | Bradley A Jackson | Radiology | 300 Pasteur Dr, Room H3630, Mc: 5642, Stanford University Med Ctr, Dept. of Int. Radiology, Stanford, CA 94305-5642 | 2008-02-07 |
1700285665 | Bradley Jackson | Specialist/Technologist | 1501 Lakeside Dr, Lynchburg, VA 24501-3113 | 2014-08-16 |
1467738195 | Bradley Jackson | Case Manager/Care Coordinator | 634 W Main St, Blytheville, AR 72315-3336 | 2011-10-26 |
1487940243 | Bradley Stevens Jackson | Emergency Medicine | 3901 Rainbow Blvd, Kansas City, KS 66103-2937 | 2011-06-21 |
1578869475 | Bradley Daniel Jackson | Nurse Anesthetist, Certified Registered | 4901 Grande Dr, Pensacola, FL 32504-5935 | 2011-02-10 |
1376787705 | Bradley A Jackson | Physical Therapist | 3135 Us Highway 41 W, Marquette, MI 49855-9494 | 2009-04-29 |
1285854737 | Bradley C Jackson | Hearing Instrument Specialist | 2969 Highway K, O Fallon, MO 63368-7862 | 2007-04-26 |
1265495329 | Bradley S Jackson | Pediatrics | 5386 Cox Smith Rd, Suite A, Mason, OH 45040-9289 | 2006-04-10 |
1750362885 | Bradley D Jackson | Chiropractor | 1261 S Main St, Meadville, PA 16335-3034 | 2005-11-07 |
Street Address |
13123 E 16TH AVE # 245 |
City | AURORA |
State | CO |
Zip Code | 80045-7106 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942817408 | Salwa Mourtada Bamba | Nurse Practitioner | University of Colorado Medicine, 12631 East 17th Avenue, Aurora, CO 80045 | 2020-09-29 |
1114545233 | Chun Cheong Tsui | Student in an Organized Health Care Education/Training Program | 12801 E. 17th Avenue, Ms 8117, Aurora, CO 80045 | 2020-07-07 |
1487278719 | James Charles Tuka IIi | Social Worker | 1700 North Wheeling, Aurora, CO 80045 | 2020-06-02 |
1427677806 | Justin Yu | Student in an Organized Health Care Education/Training Program | 12631 E. 17th Ave. Ms B205, Aurora, CO 80045 | 2020-04-15 |
1558980011 | Erik Von Polsdofer | Student in an Organized Health Care Education/Training Program | Academic Office 1; Department of Pathology, 12631 East 17th Avenue, Aurora, CO 80045 | 2020-04-14 |
1831718568 | Luke Porter Bacon | Student in an Organized Health Care Education/Training Program | 3001 East 17th Place, Aurora, CO 80045 | 2020-04-13 |
1366061368 | Hilary Novatt | Student in an Organized Health Care Education/Training Program | 12631 E 17th Ave, B198-6, Room 4007, Aurora, CO 80045 | 2020-04-10 |
1376195362 | Katie Tuck | Pharmacist | 1700 North Wheeling Street (119), Fs-111o, Aurora, CO 80045 | 2019-07-10 |
1518529130 | Ronak Kamal Kapadia | Student in an Organized Health Care Education/Training Program | 12700 E. 19th Ave, Ms B182 Rm 5104, Aurora, CO 80045 | 2019-07-03 |
1245898253 | Rasha Elbadry Ahmed | Student in an Organized Health Care Education/Training Program | Childrens Hospital Colorado Pediatric Neurosurgery, 13123e. 16th Ave, B330, Aurora, CO 80045 | 2019-06-04 |
Find all providers in zip 80045 |
Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811301153 | Rachel Ahern | Psychologist | 1298 Peoria St, Aurora, CO 80011-6206 | 2014-06-15 |
1275856890 | Idalia Massa | Psychologist | 12631 E 17th Ave Rm 3408, Blg: Ao1, Ms: F406, Uc School of Medicine, Aurora, CO 80045-2527 | 2010-03-10 |
1851546394 | Ashley Danner Sward | Psychologist | 13001 E 17th Ave Fl 2, Aurora, CO 80045-2505 | 2008-11-25 |
1447800859 | Layla Leilani Schimmel | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2019-09-17 |
1881247401 | Courtney Lynn | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2019-07-23 |
1326509738 | Michelle Clementi | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2019-03-28 |
1851886584 | Catherine Naclerio | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2018-06-25 |
1679083992 | Alexandra Ament | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2017-10-02 |
1326564428 | Catherine Wolcott | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2017-08-21 |
1205365442 | Joelle Krantz | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2017-06-10 |
Find all providers in AURORA |
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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.