AUSTIN JACKSON (NPI# 1942809868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942809868 |
| Entity Type | Individual |
| Full Name | AUSTIN JACKSON |
| Practice Address |
18609 Rt. 52 Genoa WV 22517 |
| Mailing Address |
3609 Hughes St Huntington WV 25704-1952 |
| Practice Telephone | 3042722226 |
| Mailing Telephone | 3044290070 |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
WV | Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194242388 | Austin Jacob Jackson | Physical Therapist | 8755 S Harlem Ave, Bridgeview, IL 60455 | 2017-08-28 |
| Street Address |
18609 RT. 52 |
| City | GENOA |
| State | WV |
| Zip Code | 22517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700721 | Tabitha Jo Isaacs | Technician | 650 Deephole Branch Rd, Genoa, WV 25517-7941 | 2020-11-06 |
| 1285235291 | Lydia Devon Bowen | Technician | 830 Deephole Branch Rd, Genoa, WV 25517-7704 | 2020-11-05 |
| 1538768734 | Katrina Michelle Marcum | Technician | 21846 Route 152, Genoa, WV 25517-5001 | 2020-10-20 |
| 1629681333 | Amanda Dawn Hamm | Technician | 1148 Drift Creek Road, Genoa, WV 25517 | 2020-08-24 |
| 1932710951 | Martha Ann Brewer | Technician | 715 Lambert Branch Rd, Genoa, WV 25517-7884 | 2020-08-13 |
| 1265042105 | Carolyn Sue Thompson | Technician | 759 Grassy Fork of Mill Creek Rd, Genoa, WV 25517-8037 | 2020-08-05 |
| 1700496791 | Brenda Lee Christian | Technician | 822 Drift Creek Roadd, Genoa, WV 25517 | 2020-08-04 |
| 1447860887 | Tamara Lee Christian | Technician | 822 Drift Creek Rd, Genoa, WV 25517-7938 | 2020-07-31 |
| 1689284028 | Angela Renee Carter | Technician | 840 Drift Creek Rd, Genoa, WV 25517-7938 | 2020-07-31 |
| 1811510746 | Janel Denise Adams | Technician | 2513 Big Lynn Creek Rd, Genoa, WV 25517 | 2020-05-27 |
| Find all providers in GENOA | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700721 | Tabitha Jo Isaacs | Technician | 650 Deephole Branch Rd, Genoa, WV 25517-7941 | 2020-11-06 |
| 1285235291 | Lydia Devon Bowen | Technician | 830 Deephole Branch Rd, Genoa, WV 25517-7704 | 2020-11-05 |
| 1538768734 | Katrina Michelle Marcum | Technician | 21846 Route 152, Genoa, WV 25517-5001 | 2020-10-20 |
| 1629681333 | Amanda Dawn Hamm | Technician | 1148 Drift Creek Road, Genoa, WV 25517 | 2020-08-24 |
| 1932710951 | Martha Ann Brewer | Technician | 715 Lambert Branch Rd, Genoa, WV 25517-7884 | 2020-08-13 |
| 1265042105 | Carolyn Sue Thompson | Technician | 759 Grassy Fork of Mill Creek Rd, Genoa, WV 25517-8037 | 2020-08-05 |
| 1700496791 | Brenda Lee Christian | Technician | 822 Drift Creek Roadd, Genoa, WV 25517 | 2020-08-04 |
| 1447860887 | Tamara Lee Christian | Technician | 822 Drift Creek Rd, Genoa, WV 25517-7938 | 2020-07-31 |
| 1689284028 | Angela Renee Carter | Technician | 840 Drift Creek Rd, Genoa, WV 25517-7938 | 2020-07-31 |
| 1811510746 | Janel Denise Adams | Technician | 2513 Big Lynn Creek Rd, Genoa, WV 25517 | 2020-05-27 |
| Find all providers in GENOA | ||||
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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.