MR. GILLIAN JACKSON (NPI# 1871579219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871579219 |
| Entity Type | Individual |
| Full Name | MR. GILLIAN JACKSON |
| Credential | PT |
| Practice Address |
483 W. Seed Farm Rd. Sacaton AZ 85147-0038 |
| Mailing Address |
Po Box 38 Sacaton AZ 85147-0038 |
| Practice Telephone | 6025281200 |
| Practice Fax Number | 6025281255 |
| Mailing Telephone | 6025281200 |
| Mailing Fax Number | 6025281255 |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2015-11-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | PT30262 | AZ | Other Service Providers |
| Street Address |
483 W. SEED FARM RD. |
| City | SACATON |
| State | AZ |
| Zip Code | 85147-0038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316941867 | Ronald Eugene Morehouse | Physician Assistant | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2005-06-10 |
| 1154808780 | Brady Glenn Lybbert | Dentist | 483 W. Seed Farm Rd., Sacaton, AZ 85147 | 2018-07-26 |
| 1598257248 | Corinne C Ciuris | Dietitian, Registered | 483 W. Seed Farm Rd., Sacaton, AZ 85043 | 2018-05-30 |
| 1598256398 | Phil Armando Sanchez | Social Worker | 483 W. Seed Farm Rd., Icm - Behavioral Health, Sacaton, AZ 85147 | 2018-05-29 |
| 1710414503 | Vicki Stevenson | Social Worker | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2017-05-11 |
| 1124569892 | Dustin Akina | Physical Therapist | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2017-03-15 |
| 1346791571 | Emily Perkins | Dietitian, Registered | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2016-10-24 |
| 1861852329 | Christine Waite | Dietitian, Registered | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2016-02-26 |
| 1912366980 | Rosalinda Sigarroba | Counselor | 483 W. Seed Farm Rd., Sacaton, AZ 85147 | 2016-02-18 |
| 1447619523 | Manny Athans | Counselor | 483 W. Seed Farm Rd., Sacaton, AZ 85147 | 2016-02-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104452507 | Jeremy James Pumphrey | Counselor | 438 W Seed Farm Rd, Sacaton, AZ 85147 | 2020-03-17 |
| 1215563804 | Leo Oswaldo Merino | Counselor | 291 W. Casa Blanca Rd. Bldg. # 7, Sacaton, AZ 85147 | 2020-03-16 |
| 1588166896 | Stephanie Lashawn Brown | Social Worker | 483 West Seed Farm Rd., Sacaton, AZ 85147 | 2018-03-02 |
| 1255602447 | Joyce Mildred Villalobos | Counselor | Gila River Health Care Corp, 483 W Seed Farm Rd, Sacaton, AZ 85147 | 2012-01-19 |
| 1417237074 | Gila River Health Care | Community/Behavioral Health | 291 W Casa Blanca Rd, Sacaton, AZ 85147 | 2011-08-26 |
| 1750598322 | Kari Beth Harris | Social Worker | 198 South Skill Center Road, Sacaton, AZ 85147 | 2007-05-16 |
| 1740378694 | Vincent Anthony Berkley | Internal Medicine | 198 S. Skill Center Road, Sacaton, AZ 85147 | 2006-10-10 |
| 1568448801 | Wesley Neil Yamada | Podiatrist | 483 W Seed Farm Road, Sacaton, AZ 85147 | 2005-12-19 |
| 1376532515 | Frances Antone | Physician Assistant | 483 W Seed Farm Rd., Sacaton, AZ 85147 | 2005-10-20 |
| 1538167051 | Xuong Wilkinson | Family Medicine | 483 West Seed Farm Road, Sacaton, AZ 85147 | 2005-07-08 |
| Find all providers in zip 85147 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407166226 | Michael Bond | Specialist | 483 W. Seed Farm Rd., Sacaton, AZ 85147-0038 | 2010-10-14 |
| 1518944891 | Robert Jeffrey Marotz | Specialist | 483 W. Seed Farm Rd., Sacaton, AZ 85147 | 2005-12-28 |
| 1912983248 | Steve P Schoffstall | Specialist | 483 W. Seed Farm Rd., Sacaton, AZ 85247 | 2005-12-19 |
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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.