LILLIE JACKSON (NPI# 1881047710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881047710 |
| Entity Type | Individual |
| Full Name | LILLIE JACKSON |
| Credential | PA |
| Practice Address |
4704 Cahaba River Rd # 101d Birmingham AL 35243-2344 |
| Mailing Address |
Po Box 2391 Birmingham AL 35201-2391 |
| Practice Telephone | 2057392266 |
| Practice Fax Number | 2057392335 |
| Mailing Telephone | 2058682000 |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2018-12-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA.1146 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3800 Ridgeway Dr, Birmingham, AL 352095506 | 2058682000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174039945 | Lillie Pearl Jackson | Licensed Practical Nurse | 1611 W 35th St, Riviera Beach, FL 33404-2925 | 2017-12-15 |
| 1427331735 | Lillie R. Jackson | Ambulance | 600 Kenrick Dr Ste C26, Houston, TX 77060-3698 | 2011-09-22 |
| 1841772183 | Lillie Jackson | Social Worker | 333 S Main St Ste 607, Akron, OH 44308-1228 | 2018-09-04 |
| 1649626417 | Lillie Jackson | Rehabilitation Practitioner | 3680 N Rancho Dr, Las Vegas, NV 89130-3180 | 2016-05-10 |
| 1982025771 | Lillie Pearl Jackson | Community Health Worker | 2401 Buena Vista Rd, Columbus, GA 31906-3142 | 2013-12-20 |
| Street Address |
4704 CAHABA RIVER RD # 101D |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35243-2344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588205223 | See Inc | Optometrist | 200 Summit Blvd, Suite 168, Birmingham, AL 35243 | 2019-10-03 |
| 1619526829 | Kourtni Brooke Young | Nurse Anesthetist, Certified Registered | Grandview Medical Center, 3690 Grandview Parkway, Birmingham, AL 35243 | 2019-09-10 |
| 1548747942 | Kaitlyn Bennett | Occupational Therapist | 3140 Cahaba Heights Road, Suite 102, Vestavia, AL 35243 | 2018-07-27 |
| 1013407675 | Alabama Radiation Therapy Services | Radiology | 3670 Grandview Pkwy #100, Birmingham, AL 35243 | 2018-05-18 |
| 1184169559 | Olivia Diann Gaston | Behavioral Analyst | 3296 Cahaba Heights Rd., Milestones Behavior Group., Vestavia, AL 35243 | 2016-12-21 |
| 1679027841 | Aspire Physical Recovery Center At Cahaba River, LLC | Skilled Nursing Facility | 3070 Healthy Way, Vestavia, AL 35243 | 2016-08-05 |
| 1306203682 | Abbey Elizabeth Duke | Physician Assistant | 3690 Grandview Parkway, Birmingham, AL 35243 | 2016-01-18 |
| 1689078628 | Mary Camp | Occupational Therapist | 3140 Cahaba Heights Road Suite 102, Vestavia Hills, AL 35243 | 2014-10-20 |
| 1255757209 | Laura Romundstad | Nurse Practitioner | 3670 Grandview Parkway, Suite 100, Birmingham, AL 35243 | 2014-03-14 |
| 1841631199 | Seth Alexander Martin | Developmental Therapist | 3981 Kyle Lane, Milestones Behavior Consulting, Vestavia, AL 35243 | 2013-07-16 |
| Find all providers in zip 35243 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679295 | Maltiece O'neal El | Physician Assistant | 1331 14th Ave S Apt 12, Birmingham, AL 35205-5341 | 2020-11-02 |
| 1477164580 | Rebecca Diane Davis | Physician Assistant | 701 S. 19th St, Lhr 112, Birmingham, AL 35233 | 2020-08-12 |
| 1437769981 | Kelsey Marie Robinson | Physician Assistant | 2400 Mahaska Dr, Birmingham, AL 35244-2241 | 2020-08-08 |
| 1508475740 | Stephanie Joseph Gilkey | Physician Assistant | 1505 Pleasant Ct, Birmingham, MI 48009-2909 | 2020-07-23 |
| 1619591922 | Alec Weil | Physician Assistant | 1400 19th St S, Birmingham, AL 35205-4903 | 2020-06-02 |
| 1689293888 | Molly Lynn Miller | Physician Assistant | 619 19th St S Fl 6, Birmingham, AL 35249-1900 | 2020-04-09 |
| 1730712571 | Emily Fallon Wilson | Physician Assistant | 3686 Grandview Pkwy Ste 530, Birmingham, AL 35243-3405 | 2020-02-20 |
| 1538791074 | Caroline Garrison Inge | Physician Assistant | 2700 10th Ave S Ste 505, Birmingham, AL 35205-1250 | 2020-02-11 |
| 1770114274 | Christopher Hopfner | Physician Assistant | 1809 Haynes St, Birmingham, MI 48009-6822 | 2020-02-03 |
| 1821550815 | Rebecca Brajak | Physician Assistant | 48 Medical Park Dr E Ste 150, Birmingham, AL 35235-3456 | 2019-04-01 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35243 |
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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.