MS. ELISE M JACKSON (NPI# 1932412343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932412343 |
| Entity Type | Individual |
| Full Name | MS. ELISE M JACKSON |
| Credential | DPT |
| Practice Address |
601 Childrens Ln Norfolk VA 23507-1910 |
| Mailing Address |
1008 Brandon Ave Apt 4b Norfolk VA 23507-1153 |
| Practice Telephone | 7576687000 |
| Mailing Telephone | 7576689015 |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2010-07-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
2305206461 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | VIRGINIA BOARD OF PHYSICAL THERAPY LICENSE | 2305206461 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023533973 | Elise Laura Jackson | Physical Therapist | 51 Water St # 205, Watertown, MA 02472-4611 | 2017-08-11 |
| Street Address |
601 CHILDRENS LN |
| City | NORFOLK |
| State | VA |
| Zip Code | 23507-1910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003812835 | Peter M Dozier | Psychiatry & Neurology | 601 Childrens Ln, Norfolk, VA 23507-1910 | 2005-06-27 |
| 1174122535 | Kristen Marie Atkins | Nurse Practitioner | 601 Childrens Ln, Norfolk, VA 23507-1971 | 2020-10-18 |
| 1538767066 | Victoria M Cartagena | Social Worker | 601 Childrens Ln, Norfolk, VA 23507-1971 | 2020-10-16 |
| 1922624790 | Kelsey Marie Stroud | Nurse Practitioner | 601 Childrens Ln, Norfolk, VA 23507-1910 | 2020-06-17 |
| 1932722626 | Amanda Petroski | Specialist/Technologist, Other | 601 Childrens Ln, Norfolk, VA 23507-1910 | 2020-05-28 |
| 1659994614 | Dominique A. Watt | Social Worker | 601 Childrens Ln, Norfolk, VA 23507-1971 | 2020-05-26 |
| 1336762749 | Christopher Michael Spencer | Genetic Counselor, MS | 601 Childrens Ln, Norfolk, VA 23507-1910 | 2020-05-20 |
| 1720608599 | Caitlin Dorman | Registered Nurse | 601 Childrens Ln, Norfolk, VA 23507-1971 | 2020-04-22 |
| 1093335382 | Emilie Marie Heidel | Student in an Organized Health Care Education/Training Program | 601 Childrens Ln, Norfolk, VA 23507-1910 | 2020-04-16 |
| 1700405107 | Erin Kelley Swartz | Genetic Counselor, MS | 601 Childrens Ln, Norfolk, VA 23507-1910 | 2020-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306801 | Paolo Quentin Rigo | Student in an Organized Health Care Education/Training Program | Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-04-29 |
| 1811526221 | Sean M Whitty | Student in an Organized Health Care Education/Training Program | Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 | 2020-04-07 |
| 1962030643 | Shekinah Joy Vaughn | Student in an Organized Health Care Education/Training Program | 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 | 2020-03-30 |
| 1982231403 | Jaxon Vallely | Student in an Organized Health Care Education/Training Program | 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-03-25 |
| 1437714656 | Kanishk Deep Sharma | Student in an Organized Health Care Education/Training Program | 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 | 2019-05-02 |
| 1619439460 | Dylan Woolum | Student in an Organized Health Care Education/Training Program | Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 | 2019-04-02 |
| 1477012623 | Jessie R Jones | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 | 2019-03-18 |
| 1316416787 | Lindsey Sawyer | Genetic Counselor, MS | Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 | 2018-11-15 |
| 1881188159 | Patrick Michael Haar | Pharmacist | 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 | 2018-06-19 |
| 1316438377 | Monika Pajhal | Student in an Organized Health Care Education/Training Program | Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 | 2018-05-25 |
| Find all providers in zip 23507 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548480262 | Mary Kaye Tyson | Physical Therapist | 171 Kempsville Rd Bldg A, Norfolk, VA 23502-4700 | 2007-04-26 |
| 1629596754 | Susan Michelle Cook | Physical Therapist | 7000 W Tanners Creek Dr, Norfolk, VA 23513-1151 | 2017-09-08 |
| 1588859755 | Gina Rose Mirenzi | Physical Therapist | 601 Childrens Ln, 5th Floor Ot/pt/st, Norfolk, VA 23507-1910 | 2007-09-11 |
| 1790998391 | Shelley Canada | Physical Therapist | 601 Childrens Ln, Norfolk, VA 23507-1910 | 2007-05-08 |
| 1184791915 | Amy Jo Hughes | Physical Therapist | 110 North 37th Street, Unit 101, Norfolk, NE 68701-4423 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790334175 | Elizabeth Huff | Physical Therapist | 601 S Carlin Springs Rd Ste 505, Arlington, VA 22204-1044 | 2019-09-09 |
| 1851946503 | Courtney E Marin | Physical Therapist | 2235 Tacketts Mill Dr Bldg C, Woodbridge, VA 22192-3036 | 2019-08-08 |
| 1912475419 | Kelly Laughlin | Physical Therapist | 3544 36th Rd N, Arlington, VA 22207-4817 | 2018-11-02 |
| 1336622257 | Progressive Pediatric Therapy | Physical Therapist | 150 S. Washington St., #203, Falls Church, VA 22124 | 2018-09-07 |
| 1013413699 | Melissa Anne Casey | Physical Therapist | 778 Springsbury Rd, Berryville, VA 22611-1513 | 2018-04-03 |
| 1316443336 | Rhea Amber Whitlock | Physical Therapist | 615 East St, Blackstone, VA 23824-2231 | 2018-03-30 |
| 1821507062 | Jennifer Lewis | Physical Therapist | 6856 Richmond Highway, Alexandria, VA 22306 | 2017-09-20 |
| 1144758889 | Kristen Michelle Mcbee | Physical Therapist | 2781 Jefferson Davis Hwy, Stafford, VA 22554-8322 | 2017-05-25 |
| 1316313588 | Elizabeth Anne Brewer | Physical Therapist | 23 Curle Road, Hampton, VA 23669 | 2015-08-11 |
| 1912300377 | Kiley Coleman Gibbs | Physical Therapist | 21631 Ridgetop Cir Ste 225a, Sterling, VA 20166 | 2014-09-30 |
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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.