TRACY A JACKSON (NPI# 1821177692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821177692 |
| Entity Type | Individual |
| Full Name | TRACY A JACKSON |
| Credential | O.D. |
| Practice Address |
424 W State Highway 5 Waconia MN 55387-1723 |
| Practice Telephone | 9524424461 |
| Practice Fax Number | 9524421218 |
| Mailing Telephone | 9524424461 |
| Mailing Fax Number | 9524421218 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2905 | MN | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639611486 | Tracy Lynn Jackson | Behavior Technician | 412 S Central Ave, Idabel, OK 74745-6060 | 2016-11-10 |
| 1952779209 | Tracy Jackson | Nurse's Aide | 11210 Orville Ave, Cleveland, OH 44106-1327 | 2015-09-03 |
| 1982902516 | Tracy Ann Jackson | Speech-Language Pathologist | 6395 Polo Club Dr, Cumming, GA 30040-5716 | 2011-03-07 |
| 1154436590 | Tracy P Jackson | Anesthesiology | 719 Thompson Ln Ste 22209, Nashville, TN 37204-4692 | 2006-08-19 |
| 1740203496 | Tracy Leslie Jackson | Dentist | 1731 Manatee Ave E, Bradenton, FL 34208 | 2006-07-25 |
| 1568879732 | Tracy Jackson | Counselor | 24077 State Highway 49, Nevada City, CA 95959-8519 | 2014-07-18 |
| 1992003594 | Tracy Elaine Jackson | Pharmacist | 1000 Broad St, Sumter, SC 29150-2505 | 2011-03-05 |
| 1871894899 | Tracy I Jackson | Registered Nurse | 2209 Howard St, Evanston, IL 60202-3636 | 2010-11-08 |
| 1932334091 | Tracy Jackson | Nurse Practitioner | 1389 N Baldwin Ave, Marion, IN 46952-1913 | 2009-05-19 |
| 1295902971 | Tracy Jackson | Registered Nurse | 1487 W Keiser Ave, Osceola, AR 72370-2806 | 2008-05-13 |
| Street Address |
424 W STATE HIGHWAY 5 |
| City | WACONIA |
| State | MN |
| Zip Code | 55387-1723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891725727 | Jaimee Danielle Mcpadden | Family Medicine | 424 W State Highway 5, Waconia, MN 55387-1723 | 2006-07-04 |
| 1518464601 | Alicia Pysick | Nurse Practitioner | 424 W State Highway 5, Waconia, MN 55387-1795 | 2018-04-06 |
| 1427561802 | Ashley Sivanich | Physician Assistant | 424 W State Highway 5, Waconia, MN 55387-1723 | 2017-11-08 |
| 1295180586 | Abigail Krin Elliott | Family Medicine | 424 W State Highway 5, Waconia, MN 55387-1723 | 2016-04-25 |
| 1487037073 | Erin Kathleen Dahn | Registered Nurse | 424 W State Highway 5, Waconia, MN 55387-1723 | 2015-07-01 |
| 1407199110 | David J C Arens | Podiatrist | 424 W State Highway 5, Waconia, MN 55387-1723 | 2013-04-01 |
| 1821379272 | Tracy Lynn Ingham | Nurse Practitioner | 424 W State Highway 5, Lakeview Clinic Ltd, Waconia, MN 55387-1723 | 2011-08-30 |
| 1669608352 | Jennifer Kristin Ische | Family Medicine | 424 W State Highway 5, Waconia, MN 55387-1723 | 2009-06-08 |
| 1255573416 | Erin Luann Chinnock | Obstetrics & Gynecology | 424 W State Highway 5, Waconia, MN 55387-1723 | 2009-04-01 |
| 1134368160 | Tara Lynn Mcmichael | Internal Medicine | 424 W State Highway 5, Waconia, MN 55387-1723 | 2009-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023626256 | Katelyn Neufeld | Midwife | Western Obgyn 560 S Maple St, Suite 130, Waconia, MN 55387 | 2020-07-14 |
| 1871074674 | Ashley Bea Johnson | Registered Nurse | 1866 Sandbar Cir, Waconia, MN 55387 | 2018-08-28 |
| 1740642529 | Ryan Christenson | Chiropractor | 32 E Main St., Waconia, MN 55387 | 2016-03-22 |
| 1942638481 | Katie Elizabeth Leuning-pavek | Marriage & Family Therapist | 1657 Interlaken Ct, Waconia, MN 55387 | 2013-10-18 |
| 1083964837 | Auburn Meadows, LLC | Assisted Living Facility | 591 S. Cherry Dr, Waconia, MN 55387 | 2012-09-19 |
| 1114238821 | Jalissa Joy Kruckman | Dentist | 576 Cherry Dr, Waconia, MN 55387 | 2010-06-28 |
| 1194990143 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 121 Depot Dr, Waconia, MN 55387 | 2008-04-29 |
| 1417156662 | Heather Anne Noel Tuttle | Optometrist | 753 Marketplace Drive, Waconia, MN 55387 | 2007-07-17 |
| 1366507436 | Waconia School District | Local Education Agency (LEA) | 512 Industrial Blvd, Waconia, MN 55387 | 2006-12-27 |
| 1295898872 | Haven Chemical Health Systems | Counselor | 233 1st St W, Waconia, MN 55387 | 2006-12-18 |
| Find all providers in zip 55387 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417156662 | Heather Anne Noel Tuttle | Optometrist | 753 Marketplace Drive, Waconia, MN 55387 | 2007-07-17 |
| 1992082382 | Precision Eye Care, LLC | Optometrist | 753 Marketplace Drive, Waconia, MN 55387 | 2011-11-14 |
| 1528147279 | Bradley J Ludwig | Optometrist | 424 W State Highway 5, Waconia, MN 55387-1723 | 2006-11-03 |
| 1538264981 | Edina Eye Physicians and Surgeons Pa | Optometrist | 560 S Maple St, Suite110, Waconia, MN 55387-1763 | 2006-09-13 |
| 1194790246 | Robert Eugene Swanson | Optometrist | 560 S Maple St, Suite 110, Waconia, MN 55387-1733 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615069 | Eagan Eye Clinic LLC | Optometrist | 12390 Sherburne Ave, Becker, MN 55308-9147 | 2020-10-02 |
| 1750998100 | Infinity Eye Care | Optometrist | 1275 Ramsey St Ste 700, Shakopee, MN 55379-3131 | 2020-09-29 |
| 1831700798 | Muychi Timothy Vang | Optometrist | 11217 Commerce Dr N, Champlin, MN 55316-3122 | 2020-08-13 |
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1699399592 | Nicole Rene Schmiedt | Optometrist | 400 Selby Ave Apt 221, Saint Paul, MN 55102-4509 | 2020-06-05 |
| 1700409885 | Russell N Osnes Od & Associates Pa | Optometrist | 1340 Duckwood Dr Ste 14, Eagan, MN 55123-2324 | 2020-05-22 |
| 1225657067 | Viginia Ho | Optometrist | 680 County Road 10 Ne, Blaine, MN 55434-2329 | 2020-04-12 |
| 1992331359 | Megan Kaye Horter | Optometrist | 1 Veterans Dr # 100-77, Minneapolis, MN 55417-2309 | 2020-03-18 |
| 1639704232 | Barton Eye Care LLC | Optometrist | 2306 S Broadway St Ste 12, Alexandria, MN 56308-1883 | 2020-03-04 |
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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.