DR. JOY JACKSON (NPI# 1811931454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811931454 |
| Entity Type | Individual |
| Full Name | DR. JOY JACKSON |
| Practice Address |
3502 W Northside Dr Jackson MS 39213-4454 |
| Practice Telephone | 6013625321 |
| Practice Fax Number | 6013642600 |
| Mailing Telephone | 6013625321 |
| Mailing Fax Number | 6013642600 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-02-28 |
| NPI Deactivation Date | 02/10/2020 |
| NPI Reactivation Date | 2020-02-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 11626 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 05556532 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801932090 | Joy Lynette Jackson | Licensed Practical Nurse | 19193 Mansfield St, Detroit, MI 48235-2316 | 2007-01-29 |
| 1962972265 | Joy L Jackson | Nurse Practitioner | 3815 River Crossing Pkwy Ste 100, Indianapolis, IN 46240-7766 | 2018-11-29 |
| 1780023283 | Joy Jackson | Nurse Practitioner | 4152 Baker St Ne, Covington, GA 30014-1404 | 2013-06-18 |
| 1700166691 | Joy Lynn Jackson | Internal Medicine | 3241 Lakeland Hills Blvd, Lakeland, FL 33805 | 2011-08-23 |
| 1699964908 | Joy Marie Jackson | Family Medicine | 15206 Parthenia St, North Hills, CA 91343-5305 | 2007-10-23 |
| Street Address |
3502 W NORTHSIDE DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39213-4454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952386559 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2005-12-07 |
| 1689217812 | Ebony Martin | Case Manager/Care Coordinator | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-10-21 |
| 1275189938 | April Terrain Perry | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213 | 2019-08-16 |
| 1013473891 | Ericia Latrice Cannon | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-02-16 |
| 1578037172 | Jennifer Henley | Internal Medicine | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-01-16 |
| 1003388968 | Tiffani Ricchele Mcknight | Social Worker | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-12-17 |
| 1356810360 | Thrishanna Clark | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-11-19 |
| 1376034660 | Sirna Musa | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-05-23 |
| 1033649058 | Central Mississippi Civic Improvement Association, Inc. | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2017-06-13 |
| 1013451780 | Katrice Pacley Andrews | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2016-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
| 1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
| 1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
| 1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
| 1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
| 1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
| 1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
| 1245663251 | Methodist Home Road Living Center | Licensed Practical Nurse | 4560 Methodist Home Road, Jackson, MS 39213 | 2013-08-13 |
| Find all providers in zip 39213 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1003470758 | Central Mississippi Health Services, Inc | Family Medicine | 3450 Highway 80 W Ste 71, Jackson, MS 39209-7201 | 2019-04-29 |
| 1922515493 | Meaghan Schenk Johnson | Family Medicine | 2969 Curran Dr N # 200, Jackson, MS 39216-4121 | 2018-01-05 |
| 1740795731 | Emily Colleen Dunaway | Family Medicine | 1227 N State St # 101, Jackson, MS 39202-2002 | 2017-12-12 |
| 1679086367 | Hope Np House Call Practice | Family Medicine | 98 Grandview Ave, Jackson, OH 45640-9090 | 2017-11-16 |
| 1427585488 | Daniel Matthew Bender | Family Medicine | 455 W Broadway Ave, Jackson, WY 83001-8639 | 2017-05-21 |
| 1891235289 | Logan Hardin | Family Medicine | 1270 Union University Dr Ste A, Jackson, TN 38305-3856 | 2017-03-03 |
| 1255782843 | Seth Tyler Koehler | Family Medicine | 2600 E Main St, Jackson, MO 63755-2473 | 2016-06-25 |
| 1720495245 | Gopi Patel | Family Medicine | 27 S Cooks Bridge Rd Ste 2-1, Jackson, NJ 08527-2524 | 2014-07-16 |
| 1154735165 | Lk Physicians Services Pllc | Family Medicine | 36 Lake Pointe Dr, Jackson, TN 38305-8113 | 2014-06-17 |
| Find all providers in JACKSON | ||||
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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.