JOHN ARCHIE JACKSON JR. (NPI# 1801439799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801439799 |
Entity Type | Individual |
Full Name | JOHN ARCHIE JACKSON JR. |
Practice Address |
209 Martin Luther King Dr Elizabethtown NC 28337 |
Mailing Address |
12500 Ormsby Dr Laurinburg NC 28352-7770 |
Practice Telephone | 9102476822 |
Practice Fax Number | 9102476829 |
Mailing Telephone | 9103184008 |
Mailing Fax Number | 9102476829 |
Enumeration Date | 2019-10-23 |
Last Update Date | 2019-10-23 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1917 | NC | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063073310 | John Jackson | Speech-Language Pathologist | 2143 Mohawk Trl, Maitland, FL 32751-3950 | 2019-06-27 |
1992202832 | John Jackson | Physical Therapy Assistant | 209 Lake St, Chittenango, NY 13037-1518 | 2018-04-08 |
1063911105 | John Martin Jackson | Physical Therapy Assistant | 11118 Lantern Way, North Chesterfield, VA 23236-3575 | 2018-02-05 |
1184164493 | John Jackson | Emergency Medical Technician, Paramedic | 137 S Newport Ave, Newport, WA 99156-1942 | 2017-03-06 |
1508236837 | John Willard Jackson | Anesthesiology | 7857 Caruth Ct, Dallas, TX 75225-8133 | 2015-09-29 |
1043572035 | John Ferndale Jackson | Behavioral Analyst | 931 Azure Heights Place, Las Vegas, NV 89110 | 2012-06-14 |
1679830558 | John Michael Jackson | Pharmacist | 1000 Castlebay, Cincinnati, OH 45245-4910 | 2012-04-18 |
1013043553 | John Phillip Jackson | Occupational Therapist | 7810 Avenue U Apt B, Lubbock, TX 79423-2430 | 2007-02-26 |
1275673451 | John W Jackson | Pharmacist | 1667 Bellemeade Dr, Altoona, PA 16602-7402 | 2007-02-07 |
1720162779 | John Andrew Jackson | Dentist | 600 Division Ave, Suite E., San Antonio, TX 78214-1350 | 2006-10-25 |
Street Address |
209 MARTIN LUTHER KING DR |
City | ELIZABETHTOWN |
State | NC |
Zip Code | 28337 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649826447 | Donna Marie Gray | Technician | 1797 Mercer Mill Rd, Elizabethtown, NC 28337 | 2019-08-16 |
1053972877 | Professional Eye Care Optometry, Pa | Optometrist | 432 W Broad St, Elizabethtown, NC 28337 | 2019-06-24 |
1255896015 | Andersons Drug Store LLC | Durable Medical Equipment & Medical Supplies | 206 S. Poplar St., Elizabethtown, NC 28337 | 2019-02-06 |
1336618602 | Genese Anderson Peed | Pharmacist | 206 South Poplar, Elizabethtown, NC 28337 | 2018-11-16 |
1528559671 | Bladen Healthcare LLC | Clinic/Center | 273 White Lake Dr, White Lake, NC 28337 | 2018-05-24 |
1821586918 | Coastal Horizons Center Inc. | Community/Behavioral Health | Coastal Horizons Center, Inc. - Bladen Day Treatment, 1496 Hwy 701 S., Elizabethtown, NC 28337 | 2018-04-25 |
1205353117 | Brianna Stalnaker | Pharmacist | 371 S Poplar St, Elizabethtown, NC 28337 | 2017-08-23 |
1982124681 | Justin M Degarmo Dmd & Ann Hamill Greene Dds Pa | Dentist | 401 Doctors Drive, Elizabethtown, NC 28337 | 2017-06-23 |
1336676121 | Megan Mcwhorter | Physical Therapy Assistant | 804 South Poplar Street, Elizabethtown, NC 28337 | 2017-05-11 |
1477084614 | Crystal Baxley Moore | Specialist | 105 East Broad St, Elizabethtown, NC 28337 | 2017-03-21 |
Find all providers in zip 28337 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851998181 | Specialistsmat Psc | Counselor | 110 Chase Way Ste 2, Elizabethtown, KY 42701-7827 | 2020-10-09 |
1710511456 | Rosenwald Life Center | Counselor | 612 E Dixie Ave, Elizabethtown, KY 42701-1077 | 2020-03-02 |
1740823228 | Tara L Govan | Counselor | 209 Martin Luther King Jr. Dr., Elizabethtown, NC 28337-2833 | 2019-10-28 |
1396397014 | Sara Elizabeth Zsigray | Counselor | 2645 Leitchfield Rd, Elizabethtown, KY 42701-8306 | 2019-07-12 |
1891284311 | Moriah J Bradley | Counselor | 1311 N Dixie Ave Bldg A, Elizabethtown, KY 42701-2621 | 2018-05-10 |
1669843710 | Theresa Waddell | Counselor | 725 New Glendale Rd, Elizabethtown, KY 42701-8373 | 2015-10-15 |
1215341821 | Kelly Devers I | Counselor | 615 Westport Rd, Elizabethtown, KY 42701-2874 | 2014-06-12 |
1093959223 | Jenafier Ae Carroll | Counselor | 312 N Mulberry St Ste 1, Elizabethtown, KY 42701-1837 | 2009-05-01 |
1255497178 | Brenda Gale Luther | Counselor | 200 Sycamore St, Suite 134, Elizabethtown, KY 42701-2469 | 2006-12-28 |
1588727838 | Naaman Center | Counselor | 4600 E Harrisburg Pike, Elizabethtown, PA 17022-9004 | 2006-12-18 |
Find all providers in ELIZABETHTOWN |
City | ELIZABETHTOWN |
Zip Code | 28337 |
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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.