RUSSELL PATRICK JACKSON (NPI# 1699322578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699322578 |
| Entity Type | Individual |
| Full Name | RUSSELL PATRICK JACKSON |
| Practice Address |
7311 E Southern Ave Apt 3064 Mesa AZ 85209-2723 |
| Practice Telephone | 8013100819 |
| Enumeration Date | 2019-08-24 |
| Last Update Date | 2019-08-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| 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 |
|---|---|---|---|---|
| 1932622867 | Russell Emanuel Jackson | Specialist/Technologist | 2115 Mellwood Ct, Toledo, OH 43613-3407 | 2017-07-23 |
| 1073752879 | Russell Brent Jackson | Orthopaedic Surgery | 155 E Sonterra Blvd Ste 111, San Antonio, TX 78258-3988 | 2009-02-18 |
| 1922008663 | Russell B Jackson | Optometrist | 210 S 100 E, Fillmore, UT 84631-2500 | 2005-07-22 |
| 1396218418 | Russell L Jackson | Case Manager/Care Coordinator | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2019-01-11 |
| 1902225519 | Russell Jackson | Physical Therapist | 1551 N Main St, Payson, UT 84651-5015 | 2014-04-10 |
| 1447406871 | Russell C Jackson | Case Manager/Care Coordinator | 715 N College Ave, El Dorado, AR 71730-4403 | 2008-08-18 |
| 1164576476 | Russell Earl Jackson | Counselor | 920 Boone St, Tupelo, MS 38804-5908 | 2007-01-23 |
| 1295895712 | Russell Jackson | Anesthesiology | 8700 Beverly Blvd, Suite 8211, West Hollywood, CA 90048-1804 | 2006-12-12 |
| 1457339517 | Russell Jackson | Radiology | 55 Fogg Rd, South Weymouth, MA 02190-2432 | 2006-01-08 |
| Street Address |
7311 E SOUTHERN AVE APT 3064 |
| City | MESA |
| State | AZ |
| Zip Code | 85209-2723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013539568 | Wingfoot Wellness & Hormones LLC | Nurse Practitioner | 2500 S Power Road, Building 7 Suite 218, Mesa, AZ 85209 | 2020-05-07 |
| 1558916247 | Shiny Susan Thomas | Family Medicine | 7615,east Baseline Road, Mesa, AZ 85209 | 2019-08-08 |
| 1245798933 | Premier Care Medical Services Pllc | Clinic/Center | 7363 E Naranja Ave, Mesa, AZ 85209 | 2019-03-12 |
| 1518450568 | Mhb Services | Internal Medicine | 1301 S Crismon Road, Mesa, AZ 85209 | 2018-06-13 |
| 1174012934 | Andrew Swenson | Student in an Organized Health Care Education/Training Program | 10238 E. Hampton #406, Mesa, AZ 85209 | 2018-05-08 |
| 1689196057 | Monica R Meyer | Registered Nurse | 2424 S Rowen, Mesa, AZ 85209 | 2017-07-07 |
| 1629507041 | Rachel Ann Navarro | Occupational Therapist | 10431 E Natal Ave, Mesa, AZ 85209 | 2017-06-08 |
| 1073041331 | Michelle Resendez | Nurse Practitioner | 2500 S Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-31 |
| 1275069569 | Michelle Amado | Nurse Practitioner | 2500 S. Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-04 |
| 1982138079 | Warren Brent Thomas | Nurse Anesthetist, Certified Registered | 10632 E Kiva Ave, Mesa, AZ 85209 | 2017-04-14 |
| Find all providers in zip 85209 | ||||
| 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 |
|---|---|---|---|---|
| 1902410053 | Sanjhavi Agarwal | Student in an Organized Health Care Education/Training Program | 5850 E Still Cir Apt 2102, Mesa, AZ 85206-3618 | 2020-09-05 |
| 1689287542 | Victoria Lyn Slaven | Student in an Organized Health Care Education/Training Program | 1342 S Revere, Mesa, AZ 85210-5124 | 2020-08-28 |
| 1588276349 | Michael Robert Nango | Student in an Organized Health Care Education/Training Program | 5058 E Greenway St, Mesa, AZ 85205-3472 | 2020-08-21 |
| 1821600701 | Landon Merkley | Student in an Organized Health Care Education/Training Program | 120 1/2 N Wilbur, Mesa, AZ 85201-6736 | 2020-08-20 |
| 1487266524 | Brittany Alexandra Day | Student in an Organized Health Care Education/Training Program | 7325 E Mills St, Mesa, AZ 85207-2043 | 2020-08-19 |
| 1386254795 | Geneal Renee Whetten | Student in an Organized Health Care Education/Training Program | 5064 E Dartmouth Cir, Mesa, AZ 85205-6424 | 2020-08-01 |
| 1144830563 | Kaitlin Anne Benga | Student in an Organized Health Care Education/Training Program | 3060 N Ridgecrest Unit 106, Mesa, AZ 85207-1087 | 2020-08-01 |
| 1154958510 | Karzan Salih | Student in an Organized Health Care Education/Training Program | 445 S Dobson Rd Apt 1034, Mesa, AZ 85202-1827 | 2020-03-25 |
| 1689201170 | Joseph Miller | Student in an Organized Health Care Education/Training Program | 5620 E Alder Ave, Mesa, AZ 85206-1506 | 2020-03-24 |
| 1912534637 | Adam Zoltan Dregely | Student in an Organized Health Care Education/Training Program | 1440 S Clearview Ave Ste 104, Mesa, AZ 85209-3381 | 2020-03-24 |
| Find all providers in MESA | ||||
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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.