MARY ANNE JACKSON (NPI# 1710938188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710938188 |
| Entity Type | Individual |
| Full Name | MARY ANNE JACKSON |
| Credential | MD |
| Practice Address |
2401 Gillham Rd Kansas City MO 64108-4619 |
| Practice Telephone | 8162343061 |
| Practice Fax Number | 8163461328 |
| Mailing Telephone | 8162343000 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2011-06-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
R8D24 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100204990A | 05 | |
| MO | 202250304 | 05 |
| Street Address |
2401 GILLHAM RD |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64108-4619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114921533 | Brent Ellis Cully | Radiology | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2005-06-13 |
| 1649878265 | Noelle Elise St. Jacques | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2020-10-15 |
| 1376150243 | Casey M Bradshaw | Nurse Practitioner | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2020-09-25 |
| 1457967606 | Jennifer Coil | Nurse Practitioner | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2020-09-22 |
| 1396359923 | Kelli Nicole Ayars | Nurse Practitioner | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2020-09-01 |
| 1407460058 | Eric Bowles | Health Educator | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2020-09-01 |
| 1740892504 | Katlyn Kelley | Nurse Practitioner | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2020-08-21 |
| 1528670759 | Sarah Carstensen | Nurse Practitioner | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2020-08-19 |
| 1619588373 | Kacie E Cass | Health Educator | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2020-08-14 |
| 1932719259 | Maureen Elizabeth Guignon | Nurse Practitioner | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2020-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194345561 | Diversity Telehealth, LLC | Health Educator | 1601 East 18th Street, 320a, Kansas City, MO 64108 | 2020-04-25 |
| 1447894092 | Claire-louise Sophia Young | Student in an Organized Health Care Education/Training Program | Truman Medical Center - Department of Pathology, 2301 Holmes, Kansas City, MO 64108 | 2019-11-06 |
| 1053962415 | Kymberly Kline | Behavior Technician | Riley Aba & Autism Center, 1936 Summit St, Kansas City, MO 64108 | 2019-09-26 |
| 1841854643 | Mallak Ahmed Ghozlan Zatreh | Student in an Organized Health Care Education/Training Program | 2301 Homes Street, Kansas City, MO 64108 | 2019-04-26 |
| 1003470881 | Sindhuja Palle | Internal Medicine | Truman Medial Center, 2301 Holmes Dept. of Interal Medicine, Kansas City, MO 64108 | 2019-04-26 |
| 1467016253 | Osama Mahmoud Okasha | Internal Medicine | Truman Medicial Center, 2301 Holmes, Dept of Internal Medicine, Kansas City, MO 64108 | 2019-04-26 |
| 1730643719 | Michele D Smith | Registered Nurse | 2101 Charlotte Street, Urology, Kansas City, MO 64108 | 2019-01-24 |
| 1437640414 | Omar Fayez Ahmad Abuqamar | Student in an Organized Health Care Education/Training Program | Truman Medical Center, 2301 Holmes St., Dept. of Internal Medicine, Kansas City, MO 64108 | 2018-05-24 |
| 1992200190 | Hannah Rebekah Hurst | Student in an Organized Health Care Education/Training Program | 2101 Charlotte St Ste 200, Kansas City, MO 64108 | 2018-03-28 |
| 1659873404 | William Andrew Carroll | Chiropractor | 313 E. 17th St. #210, Kansas City, MO 64108 | 2018-03-07 |
| Find all providers in zip 64108 | ||||
| Taxonomy Code | 2080P0208X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Infectious Diseases |
| A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184936437 | Liset Carla Olarte Carhuaz | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2010-07-01 |
| 1922249739 | Barbara Angelica Pahud | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2009-03-09 |
| 1457507832 | Jennifer Schuster | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2008-08-17 |
| 1013172055 | Rana El Feghaly | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2008-07-18 |
| 1790736510 | Christopher Joseph Harrison | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-15 |
| 1366493728 | Angela Leigh Myers | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-12 |
| 1326099714 | Douglas Scott Swanson | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-12 |
| 1154371615 | Denise Bratcher | Pediatrics | 2401 Gillham Rd, Children's Mercy Hospital and Clinics, Kansas City, MO 64108-4619 | 2006-05-12 |
| 1205884947 | V Fred Burry | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-05 |
| 1770571044 | Robyn A Livingston | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2005-10-11 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 64108 |
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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.