PAMELA DAWN RANDOLPH JACKSON


Address: 110 Irving St Nw, Washington, DC 20010
Phone: 8003530788

PAMELA DAWN RANDOLPH JACKSON (NPI# 1801813407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801813407
Entity Type Individual
Full Name PAMELA DAWN RANDOLPH JACKSON
Credential MD
Practice Address 110 Irving St Nw
Washington
DC 20010
Mailing Address 12605 Willow Marsh Lane
Bowie
MD 20720
Practice Telephone 8003530788
Practice Fax Number 8043556031
Mailing Telephone 3012621528
Mailing Fax Number 8043556031
Enumeration Date 2006-07-17
Last Update Date 2011-12-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0001X Radiology
Specialization: Radiation Oncology
DC 19357 DC Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
VA 010150469 05

Office Location

Street Address 110 IRVING ST NW
City WASHINGTON
State DC
Zip Code 20010

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578567012 Autumn C Graham Emergency Medicine 110 Irving St Nw, Washington, DC 20010-2976 2005-06-13
1730780891 Elizabeth Ann Maggio Occupational Therapist 110 Irving St Nw, Washington, DC 20010-3017 2020-11-05
1811597347 Elissa Newman Registered Nurse 110 Irving St Nw, Washington, DC 20010-3017 2020-10-26
1649879545 Lisa Marie Shine Registered Nurse 110 Irving St Nw, Washington, DC 20010-3017 2020-10-21
1629676002 Tiffany Laura Weekes Nurse Practitioner 110 Irving St Nw, Washington, DC 20010-3017 2020-10-16
1508463910 Liane Okada Nurse Practitioner 110 Irving St Nw, Washington, DC 20010-3017 2020-10-08
1548867948 Joseph Griffin Rebideaux Nurse Practitioner 110 Irving St Nw, Washington, DC 20010-3017 2020-10-08
1033716311 Chi Wing Pang Registered Nurse 110 Irving St Nw, Washington, DC 20010-3017 2020-10-08
1023615333 Theresa Howard Nurse Practitioner 110 Irving St Nw, Washington, DC 20010-3017 2020-10-08
1003423385 Gladys Tombise Ekema Nurse Practitioner 110 Irving St Nw, Washington, DC 20010-3017 2020-09-30
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134728397 Blueiris LLC Clinic/Center 3318 Georgia Ave Nw, Unit 13, Washington, DC 20010 2020-10-20
1700425618 Eve Kronzek Audiologist Children's National Hospital, 111 Michigan Ave Nw, Suite 1250, Washington, Dc, DC 20010 2019-12-26
1366085169 Jakeline Xochitl Merino Nurse Practitioner 106 Irving At Nw, Suite 419, Washington Dc, DC 20010 2019-10-24
1710548110 Ebrahim Hasan Khan Student in an Organized Health Care Education/Training Program 110 Irving St Nw Dept of Int Med, Washington, DC 20010 2019-06-26
1932660362 Matthew Joseph Moon Physician Assistant Medstar Washington Hospital Center - Sicu, 110 Irving Street Nw, Washington, DC 20010 2019-03-28
1316407463 Rabia Idrees Student in an Organized Health Care Education/Training Program 110 Irving St. Nw Dept of Internal Medicine, Washington, DC 20010 2019-03-24
1588124168 Nishita Patel Student in an Organized Health Care Education/Training Program 110 Irving St. Nw Dept of Obstetrics and Gynecology, Washington, DC 20010 2019-03-21
1861958035 Melissa Ann Williams Home Health Aide 3506 Georgia Ave Nw #102, Washington, DC 20010 2019-02-13
1073080602 Jingzhe Gao Registered Nurse Medstar National Rehabilitation Network, 102 Irving Street, Nw, Washington, DC 20010 2018-11-01
1487140737 Anees Musallam Sr. Student in an Organized Health Care Education/Training Program 110 Irving St. Nw Dept of Interventional Cardiology, Washington, DC 20010 2018-07-09
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Taxonomy Information

Taxonomy Code 2085R0001X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Radiation Oncology

Taxonomy Definition

A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1780023374 Yuan James Rao Radiology 2150 Pennsylvania Ave Nw, Dc Level, Washington, DC 20037-2003 2013-06-18
1528151990 Christina Irene Tsien Radiology 5255 Loughboro Rd Nw Bldg A1, Washington, DC 20016-2633 2006-09-30
1538266234 Nam Phong Nguyen Radiology 2041 Georgia Ave Nw Huh B810, Washington, DC 20060 2006-09-17
1073992038 Jill Remick Radiology 900 23rd St Nw, Washington, DC 20037-2342 2015-05-23
1063830347 Nitika Paudel Radiology 3800 Reservoir Rd Nw, Washington, DC 20007-2113 2014-04-03
1992141782 Jennifer Vogel Radiology 5255 Loughboro Rd Nw, Washington, DC 20016-2633 2013-05-20
1821338682 Minh-phuong Huynh-le Radiology 2150 Pennsylvania Ave Nw, Washington, DC 20037-3201 2013-02-15
1083973556 Jonathan Lischalk Radiology 3800 Reservoir Rd Nw Dept Of, Washington, DC 20007-2113 2012-05-03
1053686279 Aditya Halthore Radiology 5255 Loughboro Rd Nw, Washington, DC 20016-2633 2012-03-21
1205077781 Keith Robert Unger Radiology 3800 Reservoir Rd Nw, Washington, DC 20007-2113 2009-03-13
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City WASHINGTON
Zip Code 20010

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Dataset Information

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.

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