MS. MICHELLE A JACK (NPI# 1720165715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720165715 |
| Entity Type | Individual |
| Full Name | MS. MICHELLE A JACK |
| Credential | RN |
| Practice Address |
1425 Blue Hill Avenue Mattapan Community Health Center Mattapan MA 02126 |
| Mailing Address |
5 Seiden St Dorchester MA 02124 |
| Practice Telephone | 6178989013 |
| Practice Fax Number | 6172961421 |
| Mailing Telephone | 6178227523 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | 252437 | MA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831631779 | Michelle Jack | Physician Assistant | Stony Brook Univ Hosp 101 Nicolls Road Hsc L-4 Rm050, Stony Brook, NY 11794-4927 | 2016-11-09 |
| 1558754945 | Michelle D Jack | Counselor | 914 Baumann Dr, Grand Island, NE 68803-4401 | 2015-03-10 |
| 1386043503 | Michelle Marie Jack | Counselor | 835 3rd Ave, Suite C, Chula Vista, CA 91911-1352 | 2014-08-14 |
| 1043240898 | Michelle Jack | Physical Therapist | 21 W 86th St, Suite 101, New York, NY 10024-3616 | 2006-07-04 |
| Street Address |
1425 BLUE HILL AVENUE MATTAPAN COMMUNITY HEALTH CENTER |
| City | MATTAPAN |
| State | MA |
| Zip Code | 02126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861579856 | Marie I C St Hubert | Registered Nurse | 1425 Blue Hill Avenue, Mattapan, MA 02126 | 2006-11-01 |
| 1811036965 | Debra Sharoun Howard | Registered Nurse | 1425 Blue Hill Avenue, Mattapan Community Health Center, Mattapan, MA 02126 | 2007-02-05 |
| 1780747766 | Vanessa Gean Taylor | Registered Nurse | 1425 Blue Hill Avenue, Mattapan, MA 02126 | 2006-12-19 |
| 1124192992 | Jennifer Morisset | Registered Nurse | 1425 Blue Hill Avenue, Mattapan, MA 02126 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184280646 | Covil Home Care LLC | In Home Supportive Care | 1549 Blue Hill Ave, Mattapan, MA 02126 | 2019-05-10 |
| 1902374069 | Kasha Sarette | Social Worker | 37 Babson St, Mattapan, MA 02126 | 2018-11-07 |
| 1093231359 | Danielle Christian | Behavior Technician | 73 Catbird Ct, Mattapan, MA 02126 | 2017-08-18 |
| 1609314681 | Regis College | Hospice, Inpatient | 19 Southmere Road, Mattapan, MA 02126 | 2017-02-09 |
| 1437606001 | Betsy-lynn Ngole | Community Health Worker | 137 Savannah Ave, Boston, MA 02126 | 2016-09-01 |
| 1437535440 | Rosel Forwang Lewis | Registered Nurse | 42 Hallowell St, Mattapan, MA 02126 | 2015-08-03 |
| 1033596895 | Quality Home Care & Transportation | Transportation Broker | 93 W Selden St, Mattapan, MA 02126 | 2015-04-30 |
| 1205101565 | Clayton Mark Sandiford | Contractor | 22 Banfield Ave, Boston, MA 02126 | 2012-03-19 |
| 1790093128 | Richard Christopher Mitchell Jr. | Counselor | 32 Wellington Hill St, Mattapan, MA 02126 | 2010-09-20 |
| 1972630622 | Gemima St. Louis | Psychologist | 255 River St, Spark Center-bmc, Mattapan, MA 02126 | 2007-02-28 |
| Find all providers in zip 02126 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437535440 | Rosel Forwang Lewis | Registered Nurse | 42 Hallowell St, Mattapan, MA 02126 | 2015-08-03 |
| 1245535004 | Christiana Egwim | Registered Nurse | 650 Morton St, Mattapan, MA 02126-1578 | 2011-01-25 |
| 1093024986 | Martha Chimezie Jones | Registered Nurse | 54 Osceola St, Mattapan, MA 02126-1974 | 2010-09-27 |
| 1093022063 | Mary Nonye Onwuama | Registered Nurse | 246 Hebron St, Mattapan, MA 02126-1102 | 2010-09-10 |
| 1790924413 | Chidumga Mercy Onuigbo | Registered Nurse | 110 Livermore St, Apartment D8, Mattapan, MA 02126-1217 | 2009-02-19 |
| 1407093685 | Virgilius Uzo Mbawuike | Registered Nurse | 10 Pinewood St, Mattapan, MA 02126-1020 | 2009-01-09 |
| 1407049414 | Jemma Tinnis | Registered Nurse | 201 Delhi St, Mattapan, MA 02126-2357 | 2007-08-22 |
| 1669675310 | Melody Edwina White | Registered Nurse | 100 Wellington Hill St, Mattapan, MA 02126-1546 | 2007-06-08 |
| 1861579856 | Marie I C St Hubert | Registered Nurse | 1425 Blue Hill Avenue, Mattapan, MA 02126 | 2006-11-01 |
| 1548621048 | Corinne Sieben | Registered Nurse | 1135 Morton St, Mattapan, MA 02126-2834 | 2016-03-10 |
| Find all providers in MATTAPAN | ||||
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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.