DR. SUSAN MARIE JACKSON (NPI# 1780749671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780749671 |
| Entity Type | Individual |
| Full Name | DR. SUSAN MARIE JACKSON |
| Credential | D.O. |
| Practice Address |
25066 Sr 11 Hallstead PA 18822 |
| Mailing Address |
25054 Sr 11 Hallstead PA 18822 |
| Practice Telephone | 5708795249 |
| Practice Fax Number | 5708792418 |
| Mailing Telephone | 5708796870 |
| Mailing Fax Number | 5708796861 |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2013-05-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS015552 | PA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 244722 | NY | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 2000163890 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02903533 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407316003 | Susan Jackson | Pharmacist | 1022 Sealyham Ct, Reynoldsburg, OH 43068-4763 | 2019-03-21 |
| 1831624113 | Susan Jackson | Speech-Language Pathologist | 616 W Virginia Ave, Sebring, OH 44672-1142 | 2017-04-25 |
| 1487064986 | Susan Jackson | Social Worker | 425 W 48th St, 4k, New York, NY 10036 | 2014-05-06 |
| 1538476601 | Susan Jackson | Pharmacist | 5540 S 900 E, Salt Lake City, UT 84117-7206 | 2010-09-09 |
| 1609042639 | Susan Jackson | Physical Therapist | 3275 Soft Breeze Cir, West Melbourne, FL 32904-7710 | 2008-04-30 |
| 1073781613 | Susan Jean Jackson | Physical Therapist | 901 W 9th St Apt 414, Austin, TX 78703-4629 | 2008-02-18 |
| 1699951368 | Susan Elizabeth Jackson | Nurse Practitioner | 20 Mair Ave, Totowa, NJ 07512-2313 | 2008-01-12 |
| 1871048520 | Susan Marie Jackson | Case Manager/Care Coordinator | 1125 W 6th St, Los Angeles, CA 90017-1833 | 2016-08-23 |
| 1760835300 | Susan H Jackson | Marriage & Family Therapist | 8350 Archibald Ave Ste 125, Rancho Cucamonga, CA 91730-7701 | 2016-07-19 |
| 1962877431 | Susan Elizabeth Jackson | Nurse Practitioner | 1365 Beverly Rd, 2nd Floor, Mc Lean, VA 22101-3624 | 2015-12-09 |
| Street Address |
25066 SR 11 |
| City | HALLSTEAD |
| State | PA |
| Zip Code | 18822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558782060 | Neal Juraska | Pharmacist | 36 Rose St, Hallstead Family Pharmacy, Hallstead, PA 18822 | 2013-12-31 |
| 1942453311 | Heidi Ann Woodruff | Occupational Therapy Assistant | 616 Mountain Valley Rd, Hallstead, PA 18822 | 2008-10-29 |
| 1598842023 | Reddon Drug Co. Inc. | Durable Medical Equipment & Medical Supplies | 25059 Sr 11, Hallstead, PA 18822 | 2006-11-01 |
| 1912523689 | Hallstead Family Pharmacy LLC | Pharmacy | 36 Rose St, Hallstead, PA 18822 | 2020-06-18 |
| 1346603016 | Donna C Holinej | Pharmacist | 25059 Sr 11, Po Box L, Hallstead, PA 18822 | 2016-03-31 |
| 1356615785 | Jody Lee Verdetto | Pharmacist | 25059 Sr 11, Hallstead, PA 18822 | 2012-03-02 |
| 1629101712 | Jeffrey Gonz | Technician/Technologist | 19 Main St, Hallstead, PA 18822 | 2007-03-14 |
| 1053409227 | Binghampton Optical Inc | Eyewear Supplier (Equipment, not the service) | 19 Main St, Hallstead, PA 18822 | 2006-10-11 |
| 1164528089 | Bernard Leo Remakus | Internal Medicine | Rr2 Steam Hollow Road, Hallstead, PA 18822-0367 | 2006-09-16 |
| 1841684453 | Christina Carter | Counselor | 25066 State Route 11, Hallstead, PA 18822-8816 | 2015-03-20 |
| Find all providers in zip 18822 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442878 | Hallie Szymanski | Family Medicine | 3481 Frye Ave, Finleyville, PA 15332-1305 | 2020-09-19 |
| 1124633672 | Upmc Community Medicine, Inc | Family Medicine | 3140 Highland Rd Ste 102, Hermitage, PA 16148-4514 | 2020-09-11 |
| 1275147647 | Rebecca Diane Yeater | Family Medicine | Wellspan Family Medicine - Fairfield, 4910 Fairfield Rd, Fairfield, PA 17320 | 2020-09-03 |
| 1497369813 | Christina Socash | Family Medicine | 11335 Neiger Rd, Girard, PA 16417-9130 | 2020-09-02 |
| 1902410673 | Geisinger Clinic | Family Medicine | 20 Diana Ln, West Hazleton, PA 18202-1210 | 2020-09-01 |
| 1457964603 | Cynthia Rainey Raposas | Family Medicine | 3552 Woodside Rd, Hollidaysburg, PA 16648-5258 | 2020-08-27 |
| 1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
| 1649882275 | Blair Regenerative Medicine LLC | Family Medicine | 201 Hospital Dr Ste 2, Everett, PA 15537-7019 | 2020-08-17 |
| 1447861521 | Mature Resources Foundation | Family Medicine | 28944 Frenchville Karthaus Hwy, Frenchville, PA 16836-8834 | 2020-08-12 |
| 1619587227 | Cmp Medical LLC | Family Medicine | 3626 Sears St, Philadelphia, PA 19146-3217 | 2020-08-07 |
| Find all providers with the same taxonomy | ||||
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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.