MRS. BRITTANY AMBER JACKSON (NPI# 1730492638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730492638 |
| Entity Type | Individual |
| Full Name | MRS. BRITTANY AMBER JACKSON |
| Credential | P.A.C |
| Practice Address |
404 S Sutherland Ave Monroe NC 28112-5060 |
| Practice Telephone | 7042919267 |
| Practice Fax Number | 7047764078 |
| Mailing Telephone | 7042919267 |
| Mailing Fax Number | 7047764078 |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2016-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-02343 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MEDICARE PTAN | NCO3388C | 01 |
| NC | 8101604 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255958146 | Brittany L Jackson | Midwife | 1619 Dayton Ave Ste 109, Saint Paul, MN 55104-6276 | 2020-06-26 |
| 1992355184 | Brittany Jackson | Social Worker | 1525 Sudbury Ln Apt D, Fairborn, OH 45324-6542 | 2019-09-19 |
| 1265911259 | Brittany M Jackson | Case Manager/Care Coordinator | 908 Jeston Dr, Natchitoches, LA 71457-5908 | 2018-08-09 |
| 1033619606 | Brittany Shea Jackson | Speech-Language Pathologist | 1113 Ridgecrest Cir, Denton, TX 76205-5419 | 2018-02-20 |
| 1487189841 | Brittany Jackson | Counselor | 6210 Glen Echo Dr, Baton Rouge, LA 70812-1737 | 2017-04-24 |
| 1578917258 | Brittany Jackson | Home Health Aide | 5712 Adolpha Ave, Cleveland, OH 44127-1713 | 2016-04-19 |
| 1962825133 | Brittany Jackson | Behavioral Analyst | 464 Common St Ste 106, Belmont, MA 02478-2704 | 2014-01-24 |
| 1376971457 | Brittany Jackson | Physician Assistant | 1404 Palm Ter, Pasadena, CA 91104-5032 | 2013-10-28 |
| 1427679521 | Brittany Elissa Jackson | Behavior Technician | 2400 Se Federal Hwy Ste 220, Stuart, FL 34994-4556 | 2020-04-29 |
| 1346882388 | Brittany Jackson | Behavioral Analyst | 6030 W Oaks Blvd, Rocklin, CA 95765-5491 | 2019-10-10 |
| Street Address |
404 S SUTHERLAND AVE |
| City | MONROE |
| State | NC |
| Zip Code | 28112-5060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730148115 | Lakshmi Chalavadi | Internal Medicine | 404 S Sutherland Ave, Monroe, NC 28112-5060 | 2006-03-22 |
| 1285234203 | India Blandon Richardson | Nurse Practitioner | 404 S Sutherland Ave, Monroe, NC 28112-5060 | 2020-10-28 |
| 1346854544 | Briana Anderson | Nurse Practitioner | 404 S Sutherland Ave, Monroe, NC 28112-5060 | 2020-09-04 |
| 1235740945 | Ratna Acharya | Nurse Practitioner | 404 S Sutherland Ave, Monroe, NC 28112-5060 | 2020-08-14 |
| 1851924443 | Rahel Admassu Ayalew | Family Medicine | 404 S Sutherland Ave, Monroe, NC 28112-5060 | 2020-02-21 |
| 1467091272 | Kelly Rockholt Karagounis | Nurse Practitioner | 404 S Sutherland Ave, Monroe, NC 28112-5060 | 2019-12-26 |
| 1366086027 | Mari Peach Looney | Nurse Practitioner | 404 S Sutherland Ave, Monroe, NC 28112-5060 | 2019-11-05 |
| 1871153544 | Shejal Bhakta | Nurse Practitioner | 404 S Sutherland Ave, Monroe, NC 28112-5060 | 2019-06-16 |
| 1578129151 | Tammy Graves Ward | Nurse Practitioner | 404 S Sutherland Ave, Monroe, NC 28112-5060 | 2019-05-19 |
| 1902321425 | Erin Marie Bentley | Physician Assistant | 404 S Sutherland Ave, Monroe, NC 28112-5060 | 2017-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000620 | Paladina Health, LLC | Family Medicine | Paladina Health Monroe Campus Park, 1640 A Campus Park Drive, Monroe, NC 28112 | 2019-02-22 |
| 1073078408 | Sharelle Monique Hatley | Social Worker | 501 North Charlotte Ave, Suite C-214, Monroe, NC 28112 | 2019-02-11 |
| 1740762509 | Fox Counseling and Consulting, Pllc | Social Worker | 311 W Jefferson Street, Monroe, NC 28112 | 2018-08-29 |
| 1760976062 | Kinena J Dent-smith | Community/Behavioral Health | 207 Raymond St, Monroe, NC 28112 | 2018-06-20 |
| 1093225468 | Healthstat Onsite Clinic Parkdale Plant 21 | Preventive Medicine | 5005 Waxhaw Highway 75, Monroe, NC 28112 | 2017-10-11 |
| 1871026567 | H.o.p.e. Advancement, Inc. | Counselor | 349 Venus Street, Monroe, NC 28112 | 2017-04-10 |
| 1508304650 | Monroe Dental Clinic General Partnership | Dentist | 102 E Windsor Street, Monroe, NC 28112 | 2017-02-09 |
| 1073062865 | Garahetta Robin Sell | Massage Therapist | 600 West End Drive, Monroe, NC 28112 | 2016-09-22 |
| 1700280765 | Katherine Hartness | Massage Therapist | 205 N. Hayne St., Monroe, NC 28112 | 2014-10-20 |
| 1346655586 | Gaurav Chand | Internal Medicine | 1663 Campus Park Dr., Suite D, Monroe, NC 28112 | 2014-06-26 |
| Find all providers in zip 28112 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184246472 | Samantha Lee Kyvik | Physician Assistant | 147 Ludlam Rd, Monroe, NY 10950-4534 | 2020-05-11 |
| 1588202063 | Tova Schur | Physician Assistant | 2 Strelisk Court, Monroe, NY 10950 | 2019-12-16 |
| 1407404072 | Phong Chau Truong Tran | Physician Assistant | 696 Breedlove Dr Ste A, Monroe, GA 30655-2052 | 2019-08-27 |
| 1467014472 | Marissa L Jimenez | Physician Assistant | 1200 State Route 208 Ste 13, Monroe, NY 10950-4649 | 2019-07-01 |
| 1508366261 | Veronica Romero | Physician Assistant | 3402 Continental Dr, Monroe, NC 28110-5201 | 2018-02-19 |
| 1619480910 | Betty Yue | Physician Assistant | 16422 156th St Se, Monroe, WA 98272-2803 | 2017-11-08 |
| 1346798402 | Shari Koller | Physician Assistant | 501 State Route 208, Monroe, NY 10950-1611 | 2016-09-19 |
| 1811352321 | Amber Teegen Morton | Physician Assistant | 1663 Campus Park Dr Ste D, Monroe, NC 28112-5582 | 2015-12-28 |
| 1518343755 | Laura French Alison | Physician Assistant | 1338 E Sunset Dr Ste C, Monroe, NC 28112-4362 | 2015-08-10 |
| 1295120442 | Corrina Baglia | Physician Assistant | 907 Fitzgerald St, Monroe, NC 28112-5680 | 2015-04-04 |
| Find all providers in MONROE | ||||
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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.