MICHAEL JACKSON (NPI# 1790917318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790917318 |
| Entity Type | Individual |
| Full Name | MICHAEL JACKSON |
| Credential | DO |
| Practice Address |
620 John Paul Jones Cir Emergency Medicine Residency Portsmouth VA 23708-2197 |
| Practice Telephone | 2072942551 |
| Mailing Telephone | 2072942551 |
| Enumeration Date | 2009-08-15 |
| Last Update Date | 2016-05-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 0102202687 | VA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295345346 | Michael Frederick Jackson | Massage Therapist | 12702 E 33rd Ct, Spokane Valley, WA 99206-8372 | 2020-08-04 |
| 1295372993 | Michael Jackson | Chiropractor | 5216 Cold Springs Way, Eugene, OR 97405-5213 | 2019-12-02 |
| 1801365382 | Michael Jackson | Durable Medical Equipment & Medical Supplies | 5537b N Glenwood St Ste B, Garden City, ID 83714-1336 | 2018-11-14 |
| 1114441375 | Michael Frank Jackson Jr. | Physical Therapist | 1806 Russell Pkwy Ste 1400, Warner Robins, GA 31088-5781 | 2017-07-31 |
| 1457809931 | Michael Jackson | Counselor | 10001 W. Grand Avenue, Franklin Park, IL 60131 | 2016-09-14 |
| 1639625833 | Michael Jackson | Counselor | 128 Mute Swan Place, Newark, DE 19711 | 2016-08-28 |
| 1467823104 | Michael Jackson | Occupational Therapy Assistant | 1913 N Oakes St Apt D, Tacoma, WA 98406-7527 | 2015-10-07 |
| 1831576651 | Michael Howard Jackson | Family Medicine | 4646 Nw Fielding Road, Topeka, KS 66618 | 2015-04-30 |
| 1063809846 | Michael Jackson | Social Worker | 43518 Champlain Ct, Canton, MI 48188-1711 | 2015-04-20 |
| 1780922872 | Michael A Jackson | Pharmacist | 585 Mcwilliams Rd Se Unit 2303, Atlanta, GA 30315-7571 | 2013-01-23 |
| Street Address |
620 JOHN PAUL JONES CIR EMERGENCY MEDICINE RESIDENCY |
| City | PORTSMOUTH |
| State | VA |
| Zip Code | 23708-2197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427054840 | Debra Tooke Crowell | Registered Nurse | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2005-06-21 |
| 1659970424 | Jennifer T Birchwale | Student in an Organized Health Care Education/Training Program | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-10-22 |
| 1861091985 | Carin Kimberly Teeters | Psychologist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-10-20 |
| 1275130825 | Dartangion Pierre Walker | Dental Hygienist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-10-07 |
| 1750996054 | Kevin Wilfong | Psychologist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-09-14 |
| 1598379901 | Paula Shepard | Psychologist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-09-02 |
| 1578177234 | Rebekah Gunter | Psychologist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-09-01 |
| 1225641863 | Dylan Quoc-chuong Vu | Dentist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-08-24 |
| 1467060111 | Ili Yuan | Dentist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-07-20 |
| 1750909172 | Marsades Ceasar | Social Worker | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932724754 | William Dowling | Student in an Organized Health Care Education/Training Program | 260 John Paul Jones Circle, Fpo, AA 23708 | 2020-06-09 |
| 1760003156 | Kylie Miller | Student in an Organized Health Care Education/Training Program | 600 John Paul Jones Circle, Portsmouth, VA 23708 | 2020-04-27 |
| 1750900304 | Jonathan David Hickman | Student in an Organized Health Care Education/Training Program | Nmcp 620 John Paul Jones Cir., Bldg 3, Portsmouth, VA 23708 | 2020-04-14 |
| 1447716550 | Nathan Le Holterman | Student in an Organized Health Care Education/Training Program | Navy Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708 | 2019-02-13 |
| 1467930545 | Jonathan Volland | Dentist | Naval Medical Center - 620 John Paul Jones Cr, Portsmouth, VA 23708 | 2018-08-01 |
| 1629570171 | Brendan James O'shea | Student in an Organized Health Care Education/Training Program | 690 John Paul Jones Circle, Fpo, AA 23708 | 2018-03-01 |
| 1467909077 | Patricia Hicks Smith | Nurse Practitioner | 620 John Paul Jones Blvd., Naval Medical Center Portsmouth, Portsmouth, VA 23708 | 2016-09-01 |
| 1790139392 | Lauren Pitters | Student in an Organized Health Care Education/Training Program | 620 John Paul Jones Circle Drive, Naval Medical Center Portsmouth, Portsmouth, VA 23708 | 2016-04-20 |
| 1841683745 | Karrie Anne Brondell Walker | Student in an Organized Health Care Education/Training Program | 620 John Paul Jones, Naval Medical Center Portsmouth, Portsmouth, VA 23708 | 2015-03-17 |
| 1962821967 | Jody Manners | Psychiatry & Neurology | 620 John Paul Jones Cir # 2e, Portsmouth, VA 23708 | 2014-04-08 |
| Find all providers in zip 23708 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508183963 | Jeffrey Clarence Hope | Emergency Medicine | 333 Borthwick Ave Ste 100, Portsmouth, NH 03801 | 2010-04-26 |
| 1861450405 | Kelley A Hails | Emergency Medicine | 114 Corporate Drive, Seacoast Rejuvenation Ctr, Portsmouth, NH 03801 | 2006-05-03 |
| 1912978743 | Wayne Blackburn Wheeler | Emergency Medicine | 1610 28th St, Apt 621, Portsmouth, OH 45662-2641 | 2006-01-30 |
| 1730159179 | Guido Francisco Valdes | Emergency Medicine | 620, John Paul Jones Circle, Portsmouth, VA 23708 | 2006-01-26 |
| 1588642680 | Jeffrey David Lightfoot | Emergency Medicine | 219 Chesapeake Ave, Portsmouth, VA 23704-1607 | 2006-01-09 |
| 1396276986 | Samantha Ward | Emergency Medicine | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2017-03-24 |
| 1962885061 | Joshua Pendl | Emergency Medicine | 1805 27th St, Portsmouth, OH 45662-2640 | 2015-07-07 |
| 1053791459 | Brandon Larrington | Emergency Medicine | 1805 27th St, Portsmouth, OH 45662-2640 | 2015-06-02 |
| 1598156689 | William David Bianchi | Emergency Medicine | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2015-02-10 |
| 1154730182 | Amanda Paden | Emergency Medicine | 1805 27th St, Portsmouth, OH 45662-2640 | 2014-08-04 |
| Find all providers in PORTSMOUTH | ||||
| City | PORTSMOUTH |
| Zip Code | 23708 |
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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.