TERRI D. JACKSON (NPI# 1750381752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750381752 |
| Entity Type | Individual |
| Full Name | TERRI D. JACKSON |
| Credential | PA-C |
| Practice Address |
3310 Live Oak St Youth & Family Center Dallas TX 75204-6153 |
| Mailing Address |
Po Box 660599 Dallas TX 75266-0599 |
| Practice Telephone | 2142661257 |
| Practice Fax Number | 2142661258 |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2009-09-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA00941 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS BLUE SHIELD | 8N4447 | 01 |
| TX | 179959502 | 05 | |
| TX | 179959501 | 05 | |
| TX | RAILROAD MEDICARE | P00051267 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699075853 | Terri Jackson | Rehabilitation Practitioner | 1104 Allure Dr, Las Vegas, NV 89128-2095 | 2010-10-21 |
| 1104057686 | Terri Whitley Jackson | Pharmacist | 11080 Greenwell Springs Rd, Baton Rouge, LA 70814 | 2009-08-02 |
| 1629546965 | Terri L Jackson | Social Worker | 108 S 5th St, Gadsden, AL 35901-4216 | 2018-11-05 |
| 1912403106 | Terri Jackson | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2018-04-05 |
| 1902052939 | Terri A. Jackson | Audiologist | 4601 Hartford St, Abilene, TX 79605-4603 | 2008-08-11 |
| 1174786784 | Terri Jackson | Registered Nurse | 10813 Tumbleweed Rd, Apple Valley, CA 92308-3628 | 2008-07-03 |
| 1023080199 | Terri Jackson | Anesthesiology | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2006-02-03 |
| Street Address |
3310 LIVE OAK ST YOUTH & FAMILY CENTER |
| City | DALLAS |
| State | TX |
| Zip Code | 75204-6153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306842216 | Khalida Yasmin | Family Medicine | 3310 Live Oak St, Dallas, TX 75204-6153 | 2005-06-24 |
| 1295151884 | Laura Fortner | Doula | 3310 Live Oak St, Suite 201, Dallas, TX 75204-6153 | 2014-03-07 |
| 1396049698 | Amerismiles Inc | Dentist | 3310 Live Oak St, Suite 200, Dallas, TX 75204-6153 | 2010-12-29 |
| 1346413317 | April Nicole Campbell | Physician Assistant | 3310 Live Oak St, Youth & Family Centers, Dallas, TX 75204-6153 | 2008-04-10 |
| 1518155258 | Audrey L. Graham, Md, Pa | Specialist | 3310 Live Oak St, 400, Dallas, TX 75204-6147 | 2007-10-09 |
| 1013102839 | Druthil Belur | Dentist | 3310 Live Oak St, #200, Dallas, TX 75204-6153 | 2007-09-14 |
| 1841485638 | Deepa Narayanan | Family Medicine | 3310 Live Oak St, Dallas, TX 75204-6153 | 2007-09-13 |
| 1053511915 | Jenaya Judonne Ward | Obstetrics & Gynecology | 3310 Live Oak St, Suite 210, Dallas, TX 75204-6153 | 2007-07-19 |
| 1447301379 | Pgvpediatrics, Pa | Pediatrics | 3310 Live Oak St, Suite 201, Dallas, TX 75204-6153 | 2007-01-16 |
| 1972688224 | Aaron Van Wright | Psychiatry & Neurology | 3310 Live Oak St, Dallas, TX 75204-6153 | 2006-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020350 | Christina Wilder | Nurse Practitioner | 821 Allen Street Apt 424, Dallas, TX 75204 | 2020-10-11 |
| 1710441803 | Axownal Monitoring, Pllc | Electrodiagnostic Medicine | 2633 Mckinney Ave Ste 130 #329, Dallas, TX 75204 | 2019-01-23 |
| 1275026221 | Taylor Houser | Advanced Practice Midwife | 3611 Swiss Ave Ste 200, Dallas, TX 75204 | 2018-06-13 |
| 1407372147 | Regan Paulsen | Counselor | 4144 N. Central Expressway 955, 955, Dallas, TX 75204 | 2017-08-15 |
| 1639621311 | Pat Thi Nguyen | Nurse Practitioner | 3133 Lemmon Ave East, Dallas, TX 75204 | 2016-10-28 |
| 1770957896 | Dendrite Monitoring Services, Pllc | Electrodiagnostic Medicine | 2633 Mckinney Ave, Ste 130 # 335, Dallas, TX 75204 | 2015-12-01 |
| 1245609858 | Heather Eileen Li | Pharmacist | 2830 State St, Dallas, TX 75204 | 2015-09-24 |
| 1437527223 | Christy Walker | Nurse Practitioner | 2420 Clark St #703, Dallas, TX 75204 | 2015-09-10 |
| 1740678077 | Margaret Dutton | Physical Therapist | 4200 Live Oak, Dallas, TX 75204 | 2015-01-09 |
| 1639579659 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 3133 Lemmon Ave E, Dallas, TX 75204 | 2014-08-27 |
| Find all providers in zip 75204 | ||||
| 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 |
|---|---|---|---|---|
| 1932700440 | Heather Weir | Physician Assistant | 7331 Gaston Ave Ste 180, Dallas, TX 75214-4131 | 2020-11-03 |
| 1225643562 | Yermiahu Levi Sarne | Physician Assistant | 6206 Preston Crest Ln, Dallas, TX 75230-1828 | 2020-09-14 |
| 1255945564 | Amanda Michelle Flores | Physician Assistant | 1801 Young St, Dallas, TX 75201 | 2020-09-03 |
| 1275151102 | Kelly Ashworth | Physician Assistant | 7331 Gaston Ave # 180, Dallas, TX 75214-4131 | 2020-07-07 |
| 1780201715 | Gabriela Yvonne Camacho | Physician Assistant | 7331 Gaston Ave Unit 180, Dallas, TX 75214-4131 | 2020-06-25 |
| 1346879699 | Ws Neuroassist, Pllc | Physician Assistant | 7324 Gaston Ave Ste 124-80, Dallas, TX 75214-6126 | 2020-04-07 |
| 1265065122 | Sarah Bell Stewart | Physician Assistant | 7811 Bryn Mawr Dr, Dallas, TX 75225-8217 | 2020-02-19 |
| 1093348237 | Meagan Lee Barry | Physician Assistant | 221 W Colorado Blvd Ste 431, Dallas, TX 75208-2312 | 2020-02-17 |
| 1245863554 | Melissa Ann Johnston | Physician Assistant | 4373 Boca Bay Dr, Dallas, TX 75244-7408 | 2020-02-14 |
| 1205479607 | Mj Surgical, Pllc | Physician Assistant | 1408 N Riverfront Blvd # 906, Dallas, TX 75207-3912 | 2019-10-18 |
| Find all providers in DALLAS | ||||
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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.