JACKIE KENNEDY (NPI# 1730497918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730497918 |
| Entity Type | Individual |
| Full Name | JACKIE KENNEDY |
| Practice Address |
3001 Hospital Dr Cheverly MD 20785-1189 |
| Mailing Address |
5426 Watercress Pl Columbia MD 21045-2454 |
| Practice Telephone | 3016182000 |
| Mailing Telephone | 4439280668 |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2012-09-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1093616 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3001 HOSPITAL DR |
| City | CHEVERLY |
| State | MD |
| Zip Code | 20785-1189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245230390 | Karyn E White | Obstetrics & Gynecology | 3001 Hospital Dr, Perinatal Diagnostic Center, Cheverly, MD 20785-1189 | 2005-07-29 |
| 1952928905 | Mariyam Ibironke Popoola | Nurse Anesthetist, Certified Registered | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-06-25 |
| 1699391771 | Theresa Kathryn Liberatori | Social Worker | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-06-24 |
| 1467078923 | Miguel Sanchez | Student in an Organized Health Care Education/Training Program | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-06-22 |
| 1487270286 | Hannah Ward Peeples | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-06-18 |
| 1346865755 | Patrick North | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-06-11 |
| 1265052658 | Andrew Brownlee Bathe | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-04-26 |
| 1730717885 | Ami Jayesh Jani | Student in an Organized Health Care Education/Training Program | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-04-01 |
| 1376170605 | Tekabe Nigussie Birhane | Student in an Organized Health Care Education/Training Program | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-03-25 |
| 1497380620 | Brittany Livingston | Social Worker | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750908067 | Alaina Paulette Ford-reese | Counselor | 95 Office Park 1895 Brightseat, Landover, MD 20785 | 2020-07-02 |
| 1578186912 | Afshan Rehman | Student in an Organized Health Care Education/Training Program | 2900 Mercy Lane, 3rd Floor, Family Health and Wellness Center, Cheverly, MD 20785 | 2020-05-20 |
| 1235751710 | Anila Rani | Student in an Organized Health Care Education/Training Program | 3001 Hospital Dr, 5th Floor, University of Maryland Prince George Hospital Center De, Cheverly, MD 20785 | 2020-05-07 |
| 1568083715 | Sonia Haider | Student in an Organized Health Care Education/Training Program | 2900 Mercy Lane 3rd Floor, Cheverly, MD 20785 | 2020-04-29 |
| 1851938138 | The Foundation Schools, Inc. | Local Education Agency (LEA) | 855 Brightseat Road, Suite 855, Landover, MD 20785 | 2019-12-05 |
| 1104480268 | Sohaib Siddiqui | Student in an Organized Health Care Education/Training Program | 2900 Mercy Lane, 3rd Floor, Cheverly, MD 20785 | 2019-04-24 |
| 1386115558 | Tameka Drummond | Speech-Language Pathologist | 1401 Nalley Terrace, Hyattsville, MD 20785 | 2018-12-16 |
| 1427528223 | Tambra M Johnson | Occupational Therapist | [email protected], 2300 Belleview Ave, Cheverly, Md 20785, Cheverly, MD 20785 | 2018-12-05 |
| 1417427097 | Bukola B Muritala | Home Health Aide | 6313 Landover Rd Apt 301, Cheverly, MD 20785 | 2018-11-27 |
| 1073091104 | Ursula Cerro | Counselor | 903 Brightseat Road, Landover, MD 20785 | 2018-07-31 |
| Find all providers in zip 20785 | ||||
| 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 |
|---|---|---|---|---|
| 1487270286 | Hannah Ward Peeples | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-06-18 |
| 1346865755 | Patrick North | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-06-11 |
| 1265052658 | Andrew Brownlee Bathe | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2020-04-26 |
| 1588224497 | Autumn Hart Stone | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2019-06-13 |
| 1932618212 | Jennifer Steffens | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2017-09-29 |
| 1518413970 | Monica King | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2016-08-26 |
| 1851744098 | Carly Moss | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2016-07-22 |
| 1871947051 | Yongtao Wang | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2016-04-14 |
| 1467819714 | Heather Hanscom | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2016-01-18 |
| 1568833671 | Helen Asmamaw Abebe | Physician Assistant | 3001 Hospital Dr, Cheverly, MD 20785-1189 | 2015-10-14 |
| Find all providers in CHEVERLY | ||||
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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.