AMBER A JACKSON (NPI# 1801263413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801263413 |
| Entity Type | Individual |
| Full Name | AMBER A JACKSON |
| Other Name | AMBER A NAGELE |
| Credential | NP |
| Practice Address |
611 W. Park St. Gastroenterology Urbana IL 61801-2500 |
| Mailing Address |
611 W. Park St. Bwpc Urbana IL 61801-2500 |
| Practice Telephone | 2173833610 |
| Practice Fax Number | 2173262704 |
| Mailing Telephone | 2173836941 |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2017-04-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209013205 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659918878 | Amber Dawn Jackson | Licensed Vocational Nurse | 117 Sw Taylor St, Burleson, TX 76028-3813 | 2019-12-06 |
| 1558923052 | Amber Hauoli Jackson | Massage Therapist | 5820 W Locksley Loop, Wasilla, AK 99623-0874 | 2019-07-03 |
| 1982172953 | Amber Jackson | Behavior Technician | Ste, LLC, 3650 Mt. Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-11-08 |
| 1790224863 | Amber Jackson | Specialist | 24 Ball Ave, Yonkers, NY 10701-5001 | 2017-02-22 |
| 1730429226 | Amber Nicole Jackson | Licensed Practical Nurse | 5963 Highland View Dr, Sylvania, OH 43560 | 2013-02-21 |
| 1295941219 | Amber Nicole Jackson | Licensed Practical Nurse | 1800 Claremore Ave, Pawhuska, OK 74056-1747 | 2007-05-15 |
| 1912944158 | Amber Adney Jackson | Social Worker | 221 N East Ave Ste 203, Fayetteville, AR 72701-5226 | 2006-05-31 |
| 1659970945 | Amber Rose Jackson | Specialist/Technologist | 12708 Riata Vista Cir Ste A106, Austin, TX 78727-7174 | 2020-10-19 |
| 1346859378 | Amber Jackson | Nurse Practitioner | 4327 Barnett Rd, Wichita Falls, TX 76310-2303 | 2020-07-27 |
| 1770105967 | Amber Jackson | Student in an Organized Health Care Education/Training Program | 300 E 6th St, Texarkana, AR 71854-5207 | 2020-05-11 |
| Street Address |
611 W. PARK ST. GASTROENTEROLOGY |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780683391 | Marshall Blake Hay | Radiology | 611 W. Park St., Radiology, Urbana, IL 61801-2530 | 2005-07-15 |
| 1780204685 | Kaitlynn Geiger | Physical Therapist | 611 W. Park St., Fapc, Urbana, IL 61801 | 2020-04-21 |
| 1134758758 | Ellen R Leskovisek | Nurse Practitioner | 611 W. Park St., Urbana, IL 61801 | 2020-04-06 |
| 1568006542 | Whitney R Streitmatter | Dietitian, Registered | 611 W. Park St., Fapc, Urbana, IL 61801 | 2019-11-01 |
| 1174165310 | Brett A Fulks | Nurse Practitioner | 611 W. Park St., Urbana, IL 61801 | 2019-10-09 |
| 1932756194 | Carissa Cole | Nurse Practitioner | 611 W. Park St., Urbana, IL 61801 | 2019-08-22 |
| 1316593221 | Xiaoyu Zhang | Speech-Language Pathologist | 611 W. Park St., Urbana, IL 61801 | 2019-08-15 |
| 1144789264 | Hannah Dignan | Nurse Practitioner | 611 W. Park St., Urbana, IL 61801 | 2019-03-18 |
| 1639644982 | Katrina Osana | Physical Therapist | 611 W. Park St., Urbana, IL 61801 | 2018-10-12 |
| 1033684170 | Kourtney L Steinkamp | Nurse Practitioner | 611 W. Park St., Hvi, Urbana, IL 61801 | 2018-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679030852 | Braden J Shaffer | Nurse Practitioner | 1400 W Park St Ste 424b, Urbana, IL 61801-2334 | 2019-02-25 |
| 1396138830 | Noemi Shilts | Nurse Practitioner | 610 N. Lincoln Ave, Urbana, IL 61801-2500 | 2015-03-09 |
| 1003165564 | Lindy Drollinger | Nurse Practitioner | 610 N. Lincoln Ave., Neurosurgery, Urbana, IL 61801-2500 | 2012-08-30 |
| 1659407088 | Peggi J White | Nurse Practitioner | 204 West University, Carle Addiction Recovery Center, Urbana, IL 61801 | 2007-02-27 |
| 1861578320 | Martha A Guyon | Nurse Practitioner | 602 W, University Avenue, Ob/gyn, Urbana, IL 61801 | 2006-10-27 |
| 1265032221 | Lindsay Roberts | Nurse Practitioner | 1818 E Windsor Rd, Urbana, IL 61802-9566 | 2020-10-29 |
| 1730786161 | Donnetta Burgess | Nurse Practitioner | 509 W University Ave, Urbana, IL 61801-1645 | 2020-10-08 |
| 1134730310 | Whitney Waterman | Nurse Practitioner | 1818 E Windsor Rd, Urbana, IL 61802-9566 | 2020-08-12 |
| 1851918874 | Jeffrey Flach | Nurse Practitioner | 611 W Park St, Urbana, IL 61801-2529 | 2020-06-26 |
| 1134758758 | Ellen R Leskovisek | Nurse Practitioner | 611 W. Park St., Urbana, IL 61801 | 2020-04-06 |
| Find all providers in URBANA | ||||
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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.