BRANDON CHRISTOPHER JACKSON (NPI# 1881030310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881030310 |
| Entity Type | Individual |
| Full Name | BRANDON CHRISTOPHER JACKSON |
| Credential | IDC |
| Practice Address |
6810 Camphor Ln San Diego CA 92139 |
| Mailing Address |
Nmcb5 Fpo AP 96601-4961 |
| Practice Telephone | 6198463392 |
| Mailing Telephone | 6198463392 |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2013-05-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IDC | 1710-1002X | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275046153 | Brandon Lamarr Jackson | Home Health Aide | 400 Brunswick St, Mooresville, NC 28115-2246 | 2017-11-14 |
| 1083163521 | Brandon Jackson | Student in an Organized Health Care Education/Training Program | 122 Lanier Dr, 322c, Statesboro, GA 30458-0804 | 2016-09-26 |
| 1861753949 | Brandon Joshua Jackson | Dentist | 70 Virginia Ave, Staten Island, NY 10305-1748 | 2012-06-05 |
| 1952340671 | Brandon Leroy Jackson | Physical Therapist | 4765 S. Durango Dr., Ste 106, Las Vegas, NV 89147 | 2006-06-06 |
| 1457994634 | Brandon Jackson | Rehabilitation Practitioner | 1873 W 54th St, Los Angeles, CA 90062-2604 | 2019-10-21 |
| 1427611151 | Brandon Clark Jackson | Social Worker | 42-77 65th Place, Woodside, NY 11377-5054 | 2019-04-18 |
| 1831658640 | Brandon Thomas Jackson | Plastic Surgery | 251 E Huron St, Chicago, IL 60611-3055 | 2019-03-19 |
| 1164952644 | Brandon Scott Jackson | Behavior Technician | 1200 W South Boulder Rd Ste 204, Lafayette, CO 80026-2833 | 2017-06-15 |
| 1578896031 | Brandon T. Jackson | Chiropractor | 1258 Bryan Rd, O Fallon, MO 63366-3771 | 2009-09-15 |
| Street Address |
6810 CAMPHOR LN |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831621689 | Paige Tetreau | Prevention Professional | 2367 Morningside St, San Diego, CA 92139 | 2017-03-31 |
| 1720316532 | Jacobi Medical Center | General Acute Care Hospital | 6861 Potomac Street, 57, San Diego, CA 92139 | 2009-12-07 |
| 1083862296 | Jennie C Bilbes | Registered Nurse | 6860 Bear Rier Row, Unit #1, San Diego, CA 92139 | 2008-08-29 |
| 1104033018 | Shanon Star Murillo | Internal Medicine | 2401 Reo Drive, San Diego, CA 92139 | 2007-05-17 |
| 1851378236 | Iyabo O Daramola | Internal Medicine | 2401 Reo Dr, San Diego, CA 92139 | 2005-12-28 |
| 1770180648 | Darius Lee Sean Woods | Military Health Care Provider | 6033 Sandy Shore Ct, San Diego, CA 92139-1014 | 2020-10-05 |
| 1134580913 | Emilio Casenave | Military Health Care Provider | 6031 Sandy Shore Ct, San Diego, CA 92139-1014 | 2016-03-08 |
| 1689934879 | Neil Allen Regero Nucup | Military Health Care Provider | 1802 Rocky Shore Rd, San Diego, CA 92139-1017 | 2012-05-21 |
| 1568855880 | Jameson Basa | Military Health Care Provider | 1976 Sky Harbor Rd, San Diego, CA 92139-1023 | 2015-03-11 |
| 1558798918 | Jesse Lee Reed | Military Health Care Provider | 6016 Rock Island Rd, San Diego, CA 92139-1030 | 2013-10-01 |
| Find all providers in zip 92139 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770180648 | Darius Lee Sean Woods | Military Health Care Provider | 6033 Sandy Shore Ct, San Diego, CA 92139-1014 | 2020-10-05 |
| 1174130744 | Daniel Carrera | Military Health Care Provider | 2645 W Canyon Ave Apt 450, San Diego, CA 92123-4700 | 2020-09-28 |
| 1316551740 | Kyle Bode Francis | Military Health Care Provider | 3149 Murray Ridge Rd, San Diego, CA 92123-2917 | 2020-09-02 |
| 1255945069 | Jeremy Lee | Military Health Care Provider | 509 Dennery Rd Apt 145, San Diego, CA 92154-8542 | 2020-08-31 |
| 1013520667 | Rashaad Brown | Military Health Care Provider | 4454 Cherokee Ave Apt 2, San Diego, CA 92116-3611 | 2020-08-24 |
| 1932711934 | Alvaro Daniel Macias | Military Health Care Provider | 8685 Rio San Diego Dr Apt 4344, San Diego, CA 92108-6560 | 2020-08-20 |
| 1689286189 | Charles Luke Morris | Military Health Care Provider | 1675 Beta Ct, San Diego, CA 92126-7060 | 2020-08-18 |
| 1255943635 | Stephon Peyton Frost | Military Health Care Provider | 2654 Mendonca Dr, San Diego, CA 92110-4263 | 2020-08-18 |
| 1184235871 | Jaden Sandi | Military Health Care Provider | Swmi Sfidc Bldg 14 34101 Farenholt Ave, San Diego, CA 92134-0001 | 2020-08-14 |
| 1477178457 | Joseph Hunter Sampson | Military Health Care Provider | 34101 Farenholt Ave #14, San Diego, CA 92134 | 2020-06-15 |
| Find all providers in SAN DIEGO | ||||
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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.