EVELYN DIANE JACKSON (NPI# 1770707093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770707093 |
| Entity Type | Individual |
| Full Name | EVELYN DIANE JACKSON |
| Other Name | EVELYN DIANE JACKSON |
| Credential | M.D. |
| Practice Address |
3416 Olandwood Ct Suite 200 Olney MD 20832-1372 |
| Practice Telephone | 3017745600 |
| Mailing Telephone | 3017745600 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2016-05-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | D25947 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 25560-1002 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275625568 | Evelyn Jackson | Military Health Care Provider | 209 Miller Loop, Fort Benning, Columbus, GA 31905-6560 | 2006-09-28 |
| 1457330821 | Evelyn Jackson | Nurse Anesthetist, Certified Registered | 5898 Augusta Ln, Grand Blanc, MI 48439-9472 | 2006-01-12 |
| 1568961837 | Evelyn Nicole Jackson | Nurse Practitioner | 36 Pemberton Cv, Jackson, TN 38305 | 2018-02-01 |
| 1326197690 | Evelyn K. Jackson | Nurse Practitioner | 6565 Fannin St, Stb 1160, Houston, TX 77030-2703 | 2007-01-09 |
| Street Address |
3416 OLANDWOOD CT SUITE 200 |
| City | OLNEY |
| State | MD |
| Zip Code | 20832-1372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568462547 | Marvin Neil Tabb | Pediatrics | 3416 Olandwood Ct, Suite 108, Olney, MD 20832-1372 | 2005-07-29 |
| 1427582402 | Stephanie Junghans | Social Worker | 3416 Olandwood Ct, Suite 201, Olney, MD 20832-1372 | 2017-04-17 |
| 1912367988 | Advanced Pain Management Specialists, LLC | Anesthesiology | 3416 Olandwood Ct, Suite 204, Olney, MD 20832-1372 | 2016-03-03 |
| 1245471564 | Julie Decarlo | Dentist | 3416 Olandwood Ct, Ste 206, Olney, MD 20832-1372 | 2009-03-17 |
| 1710161534 | Family Medical Center Pa | Family Medicine | 3416 Olandwood Ct, 207, Olney, MD 20832-1372 | 2007-12-28 |
| 1134322894 | Jil Marie Whittle | Social Worker | 3416 Olandwood Ct, Ste. 201, Olney, MD 20832-1372 | 2007-06-08 |
| 1942322680 | Garsutis K. Palys | Psychiatry & Neurology | 3416 Olandwood Ct, Suite 201, Olney, MD 20832-1372 | 2007-04-04 |
| 1356472989 | Morton Barry Albert | Psychiatry & Neurology | 3416 Olandwood Ct, Suite 201, Olney, MD 20832-1372 | 2007-03-07 |
| 1912053190 | Kitty Whitmer Albert | Registered Nurse | 3416 Olandwood Ct, Suite 201, Olney, MD 20832-1372 | 2007-01-28 |
| 1154476711 | Gail Lynn Ullrich | Social Worker | 3416 Olandwood Ct, Ste 201, Olney, MD 20832-1372 | 2007-01-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417443532 | Ludmila Costenco | Behavior Technician | 18218 Fox Chase Cir, Olney, MD 20832 | 2018-07-02 |
| 1912422874 | Shannon Denham Nguy | Nurse Practitioner | 18109 Prince Philip Dr Ste 300, Olney, MD 20832 | 2017-08-11 |
| 1578092904 | Rodney John Bohlmann | Naturopath | 17517 Queen Elizabeth Drive, Olney, MD 20832 | 2017-06-08 |
| 1972999746 | Arooj Babar | Internal Medicine | 18101 Prince Philip Dr Ste 230n, Olney, MD 20832 | 2015-04-08 |
| 1437547684 | Cynthia Ann Cook | Social Worker | 18006 Vintage River Terrace, Olney, MD 20832 | 2014-12-22 |
| 1598165334 | Gedion Haile | Pharmacist | 3110 Onley Sandy Spring Rd, Onley, MD 20832 | 2014-08-29 |
| 1285047902 | Melanie Ann Grady | Family Medicine | 18109 Prince Phillip Drive, Suite B200, Olney, MD 20832 | 2014-06-10 |
| 1063847267 | Mari Nako Tchantcho | Home Health Aide | 17149 Moss Side Lane, Olney, MD 20832 | 2013-09-06 |
| 1033558358 | Emily Sue Browning | Dentist | 3416 Olandwood Court, Suite 205, Suite 205, Olney, MD 20832 | 2013-06-19 |
| 1487093167 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 3414 Olandwood Court, Olney, MD 20832 | 2013-06-17 |
| Find all providers in zip 20832 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972999746 | Arooj Babar | Internal Medicine | 18101 Prince Philip Dr Ste 230n, Olney, MD 20832 | 2015-04-08 |
| 1427477363 | Rami Raouf Eltaraboulsi | Internal Medicine | 18111 Prince Philip Dr Ste 323, Olney, MD 20832-1507 | 2014-04-08 |
| 1891048336 | Marilyn Elizabeth Giles | Internal Medicine | 4100 Horatio Ct, Olney, MD 20832-2963 | 2012-10-22 |
| 1669636049 | Meron Yimen | Internal Medicine | 18101 Prince Philip Dr Ste 3060, Olney, MD 20832-1514 | 2008-07-15 |
| 1205098910 | Raza Shah | Internal Medicine | 2919 Olney Sandy Spring Rd Ste D, Olney, MD 20832 | 2008-06-25 |
| 1104013671 | Medical and Wellness Center of Olney | Internal Medicine | 4000 Olney-laytonsville Rd, Olney, MD 20832-1802 | 2007-09-28 |
| 1134321995 | Michael Elijah Murray | Internal Medicine | 4893 N Whitewater Rd, Olney, IL 62450-4325 | 2007-06-04 |
| 1437285855 | Estelle Darlyse Jean | Internal Medicine | Medstar Health Cardiology Associates, 1801 Prince Philip Drive, Suite 4100, Olney, MD 20832 | 2007-02-27 |
| 1619035573 | Alok Mathur | Internal Medicine | 4000 Olney Laytonsville Road, Olney, MD 20832 | 2006-12-04 |
| 1609967736 | Olney Medical Associates | Internal Medicine | 18109 Prince Philip Dr Ste 275, Olney, MD 20832-1576 | 2006-09-27 |
| Find all providers in OLNEY | ||||
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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.