ANTHONY W JACKSON SR. (NPI# 1700987062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700987062 |
| Entity Type | Individual |
| Full Name | ANTHONY W JACKSON SR. |
| Credential | MD |
| Practice Address |
105 Medical Dr Elizabeth City NC 27909-3361 |
| Practice Telephone | 2523377409 |
| Practice Fax Number | 2523377410 |
| Mailing Telephone | 2523377409 |
| Mailing Fax Number | 2523377410 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2011-01-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 2007-00605 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBSNC | 14516 | 01 |
| NC | 5906945 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689287328 | Anthony Benedict Jackson | Nurse Practitioner | 8 Radford St # 202, Christiansburg, VA 24073-3320 | 2020-08-24 |
| 1558741652 | Anthony Jackson | Case Manager/Care Coordinator | 2000 Nw 1st St, Boynton Beach, FL 33435-2286 | 2015-06-03 |
| 1922410448 | Anthony Jerome Jackson | Counselor | 1826 Chelsea Rd, Elkins Park, PA 19027-1056 | 2014-06-02 |
| 1245307073 | Anthony Jackson | Counselor | 2237 River Plaza Dr, Sacramento, CA 95833-3836 | 2006-11-29 |
| 1396838868 | Anthony Haig Jackson | Psychiatry & Neurology | 31 Woodlawn Avenue, Needham, MA 02492 | 2006-10-02 |
| 1346254596 | Anthony D Jackson | Dentist | 512 E Alexander St, Plant City, FL 33563-7165 | 2006-07-27 |
| 1720024847 | Anthony L Jackson IIi | Emergency Medicine | 2575 E Bidwell St Ste 160, Folsom, CA 95630-6446 | 2006-06-20 |
| 1568077535 | Anthony Jackson | Chore Provider | 332 S Decatur Blvd, Las Vegas, NV 89107-2804 | 2020-09-15 |
| 1487210399 | Anthony Jackson | Counselor | 5080 Florence Rd, Murfreesboro, TN 37129-2922 | 2019-05-15 |
| 1063076925 | Anthony Earle Jackson | Student in an Organized Health Care Education/Training Program | 3901 Rainbow Blvd, Kansas City, KS 66160-8500 | 2019-04-26 |
| Street Address |
105 MEDICAL DR |
| City | ELIZABETH CITY |
| State | NC |
| Zip Code | 27909-3361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104825694 | Carolina Surgical Care Associates, P. A. | Specialist | 105 Medical Dr, Elizabeth City, NC 27909-3361 | 2005-07-18 |
| 1366077687 | Melissa Smith | Counselor | 105 Medical Dr, Elizabeth City, NC 27909-3361 | 2020-03-06 |
| 1396280350 | Jk2c, LLC | Health Maintenance Organization | 105 Medical Dr, Elizabeth City, NC 27909-3361 | 2016-12-30 |
| 1124214036 | Ear,nose&throat Head,neck&sinus Surgery,pc | Clinic/Center | 105 Medical Dr, Elizabeth City, NC 27909-3361 | 2007-09-25 |
| 1942254677 | Madonna Nicole Morgan | Audiologist | 105 Medical Dr, Elizabeth City, NC 27909-3361 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482177 | Leslie Treherne-fayton Dds Pllc | Dentist | 3875 Conlon Way Ste A, Elizabeth City, NC 27909 | 2020-03-13 |
| 1053829077 | Kaitlyn Daniels | Counselor | 1825 West City Drive, Suites A&b, Elizabeth City, NC 27909 | 2018-01-11 |
| 1487183778 | Traniqua Mccullen | Social Worker | 314 Orchard Drive, Elizabeth City, NC 27909 | 2017-06-08 |
| 1760938401 | Lauren Noele Schaefer | Physical Therapist | 615 S Hughes Boulevard, Unit B, Elizabeth City, NC 27909 | 2016-09-01 |
| 1588023279 | Regina Mccoy | Nurse Practitioner | 1507 N Road St Ste 3, Elizabeth City, NC 27909 | 2016-02-23 |
| 1750753760 | Mark C. ''chris'' Patterson | Physician Assistant | Coast Guard Base Elizabeth City, 1664 Weeksville Road, Building 128, Elizabeth City, NC 27909 | 2015-10-29 |
| 1770963365 | Harlan Bradley Hurdle | Pharmacist | 104 Breezewood Drive, Elizabeth City, NC 27909 | 2015-06-09 |
| 1558779298 | Wilkiam Wilson | Counselor | 1290 Halstead Blvd, Elizabeth City, NC 27909 | 2014-07-25 |
| 1871919886 | Courtney Bunch | Specialist/Technologist | 1680 Cedar Point Circle, Elizabeth City, NC 27909 | 2014-03-14 |
| 1790100832 | The Power of U | Community/Behavioral Health | 1023 Us17s Suite 1, Elizabeth City, NC 27909 | 2014-02-26 |
| Find all providers in zip 27909 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841285293 | Albemarle Ear Nose & Throat Asthma and Allergy Associates Pa | Otolaryngology | 1134 N Road St, Bldg # 2, Elizabeth City, NC 27909-3365 | 2005-09-13 |
| 1588849319 | Casey Guy Nekl | Otolaryngology | 1134 N Road St Ste 2, Elizabeth City, NC 27909-3365 | 2007-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528605888 | Inbal Hazkani Bendror | Otolaryngology | 1217 Mossy Glade Cir, Apex, NC 27502-4874 | 2019-12-05 |
| 1174183156 | Queen City Ear Nose and Throat Pllc | Otolaryngology | 8924 Blakeney Professional Dr, Charlotte, NC 28277-6660 | 2019-06-20 |
| 1194244012 | Ethan Staats | Otolaryngology | 391 Heaton Forest Rd, Cashiers, NC 28717 | 2017-09-12 |
| 1528423068 | Charlotte Eye Ear Nose & Throat Associates, Pa | Otolaryngology | 149 Plantation Ridge Drive, Suite 190, Mooresville, NC 28117-9178 | 2015-12-29 |
| 1598151763 | Adam Richard Gigliotti | Otolaryngology | 400 E Stonewall St, Charlotte, NC 28202-3601 | 2015-04-14 |
| 1891112389 | Marshall Snow | Otolaryngology | 109 Piedmont Ave, Winston Salem, NC 27101-3607 | 2014-03-24 |
| 1073937942 | John Monroe | Otolaryngology | 525 Hardee Branch Rd, West End, NC 27376-8961 | 2014-02-12 |
| 1457794893 | Candace Mitchell Waters | Otolaryngology | 170 Manning Drive Campus Box #7070, Chapel Hill, NC 27599-4216 | 2013-04-16 |
| 1457794927 | Amanda Jo Lott Marcellino | Otolaryngology | 1132 N Church St Ste 200, Greensboro, NC 27401 | 2013-04-15 |
| 1710320510 | Nicolas-george Katsantonis | Otolaryngology | 4600 Lake Boone Trl Ste 100, Raleigh, NC 27607 | 2013-04-10 |
| Find all providers with the same taxonomy | ||||
| City | ELIZABETH CITY |
| Zip Code | 27909 |
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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.