MR. SAMUEL ROBERT JACKSON


Address: 1906 Belleview Ave Se, Roanoke, VA 24014-1838
Phone: 5409817000

MR. SAMUEL ROBERT JACKSON (NPI# 1699274993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1699274993
Entity Type Individual
Full Name MR. SAMUEL ROBERT JACKSON
Credential PA
Practice Address 1906 Belleview Ave Se
Roanoke
VA 24014-1838
Mailing Address 719 Arbutus Ave Se
Roanoke
VA 24014-2503
Practice Telephone 5409817000
Mailing Telephone 4049835673
Enumeration Date 2018-02-02
Last Update Date 2018-02-02
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 0110006058 VA Physician Assistants & Advanced Practice Nursing Providers

Other Providers SAMUEL JACKSON

NPI Name Taxonomy Address Enumeration
1811511199 Samuel Collins Jackson Physical Therapist 1125 Landau Ln, Mt Pleasant, SC 29466-7300 2020-06-03
1689105223 Samuel Barrett Jackson Internal Medicine 200 Ucla Medical Plz Ste 400, Los Angeles, CA 90095-7417 2017-03-24
1851556203 Samuel S Jackson IIi Dentist 296 White Bridge Pike, Nashville, TN 37209-3226 2008-07-25
1376151266 Samuel Eli Jackson Behavior Technician 1110 13th St Ste D, Columbus, GA 31901-2246 2020-07-16
1588204721 Samuel Richardson Jackson Physical Therapist 10438 Iron Bridge Rd, Chester, VA 23831-1427 2020-01-15
1114480001 Samuel W Jackson Student in an Organized Health Care Education/Training Program 450 Clarkson Ave, Brooklyn, NY 11203-2012 2019-04-09
1255794160 Samuel Jackson Student in an Organized Health Care Education/Training Program 4301 W Markham St, Slot 589, Little Rock, AR 72205-7101 2016-03-30

Office Location

Street Address 1906 BELLEVIEW AVE SE
City ROANOKE
State VA
Zip Code 24014-1838

Providers in the same location

NPI Name Taxonomy Address Enumeration
1053315796 Lee Ann Speed Registered Nurse 1906 Belleview Ave Se, Roanoke, VA 24014-1838 2005-06-10
1114526605 Kimberly Ann Ramsey Clinical Nurse Specialist 1906 Belleview Ave Se, Roanoke, VA 24014-1838 2020-10-26
1578181285 Sarah Lipps Pharmacist 1906 Belleview Ave Se, Roanoke, VA 24014-1838 2020-07-09
1124646831 Shannon Victoria Brown Pharmacist 1906 Belleview Ave Se, Roanoke, VA 24014-1838 2020-07-09
1285252189 Yang Zhao Pharmacist 1906 Belleview Ave Se, Roanoke, VA 24014-1838 2020-07-08
1932727831 Jonathan Zalman Pharmacist 1906 Belleview Ave Se, Roanoke, VA 24014-1838 2020-07-08
1669090569 Miranda Thomas Pharmacist 1906 Belleview Ave Se, Roanoke, VA 24014-1838 2020-07-08
1427676329 Zachary Seth Stevenson Pharmacist 1906 Belleview Ave Se, Roanoke, VA 24014-1838 2020-07-08
1053939801 Narmada Mannem Student in an Organized Health Care Education/Training Program 1906 Belleview Ave Se, Roanoke, VA 24014-1838 2020-07-08
1821616657 Vanessa Pellegrino Pharmacist 1906 Belleview Ave Se, Roanoke, VA 24014-1838 2020-07-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417558602 Irene Pace Seidman Pharmacist 3350 Clearbrook Village Ln, Roanoke, VA 24014 2020-11-04
1720617970 Mounica Reddy Thootkur Student in an Organized Health Care Education/Training Program 2017 South Jefferson Street, 2nd Floor, Roanoke, VA 24014 2020-04-08
1326675422 Bharath Muppala Student in an Organized Health Care Education/Training Program Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 2020-03-26
1235629239 Sanjeeb Sudarshan Bhandari Student in an Organized Health Care Education/Training Program 1906 Bellview Ave Se, Roanoke, VA 24014 2018-05-15
1104325778 Vera J. Short Registered Nurse 3167 Huffman Ln, Roanoke, VA 24014 2018-02-08
1770001380 Michael Alan Phillips I Social Worker 2017 Jefferson Street, Roanoke, VA 24014 2017-09-03
1306362884 Sara Alicia Guasch Student in an Organized Health Care Education/Training Program Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 2017-08-16
1790212256 Pouya Mafi Student in an Organized Health Care Education/Training Program 1906 Belleview Ave, Carilion Roanoke Memorial Hospital, Roanoke, VA 24014 2017-05-16
1790222867 Mara Cate Physician Assistant 523 Arbuttus Ave, Roanoke, VA 24014 2017-01-26
1508314634 Dknl Enterprises, Inc. Non-emergency Medical Transport (VAN) 3629 Franklin Rd Sw Suite 205b, Roanoke, VA 24014 2016-09-19
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164040960 Daniel Scott Feivor Physician Assistant 131 Campbell Ave Sw Ste 215, Roanoke, VA 24011-1241 2020-07-08
1275159287 Paige Alexandra Hamay Physician Assistant 206 Williamson Rd Se Apt 227, Roanoke, VA 24011-1812 2020-06-25
1396360624 Hannah Barnhill Physician Assistant 943 Murray Ave Se, Roanoke, VA 24013-1841 2020-06-12
1922623297 Grace G Krotkov Physician Assistant 3410 Chaparral Dr Apt 133, Roanoke, VA 24018-4930 2020-06-12
1639791270 Megan Thorn Physician Assistant 502 Allison Ave Sw Apt 5, Roanoke, VA 24016-4547 2020-05-16
1952923914 Sydney Lucille Hughes Adams Physician Assistant 928 2nd St Sw Apt 1, Roanoke, VA 24016-4420 2020-05-13
1780206268 Katherine Cole Physician Assistant 16 Old Whitmore Ave Se Apt 507, Roanoke, VA 24016-1236 2020-05-07
1205457033 Kristin Marie Sammons Physician Assistant 6430 Archcrest Dr Apt 107, Roanoke, VA 24019-1185 2020-05-04
1407480460 Amanda Joy Wheeler Physician Assistant 3626 Belle Ave Ne, Roanoke, VA 24012-6408 2020-02-28
1356981625 Ryan Maurer Short Physician Assistant 1615 Westover Ave Sw # A, Roanoke, VA 24015-5215 2020-01-14
Find all providers in ROANOKE

Competitor

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City ROANOKE
Zip Code 24014

Improve Information

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Dataset Information

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.

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