THERESA LYNN JACKSON (NPI# 1790332443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790332443 |
| Entity Type | Individual |
| Full Name | THERESA LYNN JACKSON |
| Credential | RD |
| Practice Address |
2950 Elmwood Ave Kenmore NY 14217-1304 |
| Mailing Address |
15 Brookhaven Ln Lancaster NY 14086-9568 |
| Practice Telephone | 7164476538 |
| Mailing Telephone | 7169081510 |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144767906 | Theresa A Jackson | Community Health Worker | 3112 33rd St Ne, Canton, OH 44705-3869 | 2017-01-31 |
| 1104207083 | Theresa Jackson | Chore Provider | 77 E Great Lakes St Apt 303, River Rouge, MI 48218-1584 | 2015-06-16 |
| 1164818993 | Theresa Jackson | Emergency Medicine | 4629 E 13th Pl, Tulsa, OK 74112-6103 | 2015-04-08 |
| 1063832509 | Theresa Jackson | Counselor | 18 J Braden Thompson Rd, Forestdale, MA 02644-1555 | 2014-04-23 |
| 1083947592 | Theresa Michelle Jackson | Registered Nurse | 337 E 197th St, Euclid, OH 44119-1121 | 2009-09-15 |
| 1841486289 | Theresa Y Jackson | Massage Therapist | 1803 Boulevard, Jacksonville, FL 32206-4342 | 2007-09-19 |
| 1093280422 | Theresa Jackson | Massage Therapist | 3647 Cedar Ave S, Minneapolis, MN 55407-2919 | 2018-10-12 |
| 1275021834 | Theresa E. Jackson | Social Worker | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2018-04-28 |
| 1568709335 | Theresa F Jackson | Pharmacist | 3550 Centerville Hwy, Snellville, GA 30039-4133 | 2013-01-13 |
| 1154506681 | Theresa Jackson | Social Worker | 2100 Comer Ave, Columbus, GA 31904-8725 | 2008-01-03 |
| Street Address |
2950 ELMWOOD AVE |
| City | KENMORE |
| State | NY |
| Zip Code | 14217-1304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734066 | Victoria Paulsen | Anesthesiology | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2020-06-16 |
| 1659909752 | Kenmore Mercy Hospital | Internal Medicine | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2020-04-01 |
| 1962048793 | David Michael Armstrong | Nurse Practitioner | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2019-11-27 |
| 1174058549 | Great Lakes Locums LLC | Hospitalist | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2017-04-24 |
| 1619424884 | Buffalo Niagara Hospitalist LLC | General Acute Care Hospital | 2950 Elmwood Ave, Kenmore, NY 14217 | 2016-09-06 |
| 1629525167 | Caitlin Elizabeth Ortiz | Nurse Practitioner | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2016-09-01 |
| 1255714762 | Krystal R Burns | Nurse Anesthetist, Certified Registered | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-07-01 |
| 1033591342 | Robert E Baker IIi | Physician Assistant | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-06-23 |
| 1295114601 | Jeffrey Olek | Pharmacist | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-05-19 |
| 1225416274 | Kristen Kelsey | Pharmacist | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316585201 | Emma Rae Rooney | Student in an Organized Health Care Education/Training Program | 2900 Delaware Ave., Kenmore, NY 14217 | 2019-12-11 |
| 1558801530 | Elizabeth Fazio | Local Education Agency (LEA) | 3767 Delaware Ava, Kenmore, NY 14217 | 2017-02-24 |
| 1477940393 | Laura Sabia | Case Manager/Care Coordinator | 2900 Deleware Avenue, Kenmore, NY 14217 | 2015-04-17 |
| 1770994881 | Kenmore Family Medicine | Family Medicine | 2914 Elmwood Avenue, Kenmore, NY 14217 | 2014-05-12 |
| 1144576265 | Elizabeth Anne Leiser | Nurse Practitioner | 274 W Girard Blvd, Kenmore, NY 14217 | 2012-07-26 |
| 1730442385 | Christopher Landeo | Case Manager/Care Coordinator | 2900 Delaware Avenue, Kenmore, NY 14217 | 2012-06-19 |
| 1013291095 | Sharon Karnyski | Physical Therapist | 2900 Delaware Avenu, Kenmore, NY 14217 | 2011-10-07 |
| 1164706784 | Joanne Karen Cascio | Registered Nurse | 3756 Delaware Avenue, Kenmore, NY 14217 | 2011-09-30 |
| 1467742692 | Nicole Anne Perrotta | Occupational Therapy Assistant | 3767 Delaware Avenue, Kenmore, NY 14217 | 2011-04-08 |
| 1538466511 | Diane J. Sutter, M.d., LLC | Obstetrics & Gynecology | 3800 Delaware Avenue, Suite 102, Kenmore, NY 14217 | 2011-02-28 |
| Find all providers in zip 14217 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787104 | Katelynn Faith Arndt | Dietitian, Registered | 2780 Delaware Ave Ste 2790, Kenmore, NY 14217-2748 | 2018-10-26 |
| 1487173183 | Reiko Margarete Kobayashi-wagner | Dietitian, Registered | 17512 83rd Pl Ne, C304, Kenmore, WA 98028 | 2017-09-13 |
| 1235599390 | Emily Ann Wood | Dietitian, Registered | 120 Oakridge Ave, Kenmore, NY 14217-1163 | 2016-03-02 |
| 1558772855 | Aim 2 Nourish, LLC | Dietitian, Registered | 18779 Kenlake Pl Ne, Kenmore, WA 98028-3236 | 2014-05-08 |
| 1770830069 | Amanda Cheehan | Dietitian, Registered | 408 Shepard Ave, Kenmore, NY 14217-1831 | 2012-08-06 |
| 1902107717 | Elaine Beth Valvo | Dietitian, Registered | 514 Thorncliff Rd, Kenmore, NY 14223-1100 | 2010-11-10 |
| 1669511358 | Debra Ann Boutin | Dietitian, Registered | 14500 Juanita Dr Ne, Kenmore, WA 98028-4966 | 2007-02-06 |
| 1770938383 | Julie K Baudo | Dietitian, Registered | 2914 Elmwood Ave, Kenmore, NY 14217 | 2016-05-02 |
| 1710345343 | Kenmore Family Medicine | Dietitian, Registered | 2914 Elmwood Ave, Kenmore, NY 14217-1332 | 2016-02-10 |
| 1184997249 | Anna Katarzyna Engelhaupt | Dietitian, Registered | 2950 Elmwood Ave, Nutrition Services, Kenmore, NY 14217-1304 | 2012-02-20 |
| Find all providers in KENMORE | ||||
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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.