DOUGLAS T JACKSON (NPI# 1962472407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962472407 |
| Entity Type | Individual |
| Full Name | DOUGLAS T JACKSON |
| Credential | MD |
| Practice Address |
150 Bargen St F 102 Newark NJ 07103 |
| Mailing Address |
Po Box 18925 Newark NJ 07191 |
| Practice Telephone | 9739723555 |
| Practice Fax Number | 9739723510 |
| Mailing Telephone | 9739723555 |
| Mailing Fax Number | 9739723510 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LC0200X |
Anesthesiology Specialization: Critical Care Medicine |
25MA06601400 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 6716407 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730384744 | Douglas Reed Jackson | Neuromusculoskeletal Medicine & OMM | 3211 Applewood Rd, Midland, MI 48640-2666 | 2007-06-19 |
| 1245367655 | Douglas Wayne Jackson | Dentist | 5540 S 79th E Place, Tulsa, OK 74145-7846 | 2007-02-27 |
| 1457401762 | Douglas Jackson | Dentist | 714 E. 4th Ave, Red Springs, NC 28377 | 2007-01-11 |
| 1063432342 | Douglas R Jackson | Family Medicine | 517 W Junipero St Unit 1, 334 S Patterson Ave #120, Santa Barbara, CA 93105-4239 | 2006-07-20 |
| 1760412241 | Douglas Gilbert Jackson I | Nurse Practitioner | 14827 Foothill Rd, Santa Paula, CA 93060-9733 | 2006-07-03 |
| 1184277857 | Douglas Jackson | Nurse Practitioner | 1100 Reid Pkwy, Richmond, IN 47374-1157 | 2019-07-22 |
| 1427394147 | Douglas Ray Jackson | Pharmacist | 600 Sheldon St, Creston, IA 50801-3322 | 2012-12-27 |
| 1891071635 | Douglas Scott Jackson | Pharmacist | 116 S George St, Suite 101, York, PA 17401-1474 | 2011-10-25 |
| 1013160316 | Douglas Clarence Jackson | Specialist | 2384 Atlantic Ave, Brooklyn, NY 11233-3402 | 2008-10-30 |
| 1912076639 | Douglas L Jackson | Nurse Anesthetist, Certified Registered | 100 Peyton Way, Suite 200, Charleston, WV 25309-8572 | 2006-11-07 |
| Street Address |
150 BARGEN ST F 102 |
| City | NEWARK |
| State | NJ |
| Zip Code | 07103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657077 | Yingna Liu | Student in an Organized Health Care Education/Training Program | Medical Science Building, 185 South Orange Avenue, Newark, NJ 07103 | 2020-04-03 |
| 1568029684 | Martins Akhibi | Nurse Practitioner | 178 Newton Street, Newark, NJ 07103 | 2019-05-23 |
| 1972168482 | Newark Renaissance House, Inc | Rehabilitation, Substance Use Disorder Unit | 50-56 Norfolk Street, Newark, NJ 07103 | 2019-05-09 |
| 1346709235 | Ian Wang Yu | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave., Medical Science Building, Room I-506, Newark, NJ 07103 | 2019-03-19 |
| 1437648417 | Stephen Vanbeek | Internal Medicine | 185 S Orange Ave Rm 547, Newark, NJ 07103 | 2018-05-06 |
| 1073019444 | Geoffrey Alexander Talis | Student in an Organized Health Care Education/Training Program | 183 S. Orange Avenue, Level E, Room 1452, Newark, NJ 07103 | 2018-04-03 |
| 1285139907 | Thomas Georg Bachmann | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Medical Science Building, G-538, Newark, NJ 07103 | 2018-03-26 |
| 1154825289 | Shammi A Patel | Student in an Organized Health Care Education/Training Program | 185 S Orange Ave # Msbg594, Newark, NJ 07103 | 2018-03-22 |
| 1982122545 | North Jersey Aids Alliance | Clinic/Center | 393 Central Avenue C/o Corey Destefano, Newark, NJ 07103 | 2017-09-05 |
| 1134655533 | Yasmin N Abedin | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Msb E-506, Rutgers, New Jersey Medical School, Newark, NJ 07103 | 2017-05-04 |
| Find all providers in zip 07103 | ||||
| Taxonomy Code | 207LC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Critical Care Medicine |
| An anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851433080 | University Health Partnership | Anesthesiology | 150 Bergen St, Uh F-102, Newark, NJ 07103-2496 | 2007-02-13 |
| 1609920842 | Andrei Botea | Anesthesiology | 150 Bergen St, Newark, NJ 07103-2496 | 2007-01-23 |
| 1831184225 | Anesthesia Associates At St. Michael's, LLC | Anesthesiology | 268 Martin Luther King Jr Blvd, Newark, NJ 07102-2011 | 2005-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538507389 | Bishoy F Hanna | Anesthesiology | 73 Winding Wood Dr Apt 4a, Sayreville, NJ 08872-2036 | 2013-06-13 |
| 1952649766 | Rita Grant Newman | Anesthesiology | 8 Dale Ave, Pompton Plains, NJ 07444-1339 | 2013-01-29 |
| 1689830960 | Brian Chu M.d.,p.c. | Anesthesiology | 52 Edelweiss Ln, Voorhees, NJ 08043-2819 | 2008-08-05 |
| 1326445123 | St. Luke's Warren Physician Group, PC | Anesthesiology | 185 Roseberry St, Phillipsburg, NJ 08865-1690 | 2014-11-24 |
| 1528298817 | Intensivists At Highland Pa | Anesthesiology | 1 Bay Avenue, Monclair, NJ 07042 | 2009-07-21 |
| 1104072727 | Syed Ali Riaz | Anesthesiology | 141 Route 70 E Ste B, Marlton, NJ 08053 | 2008-08-14 |
| 1700043668 | Victor I Adamov | Anesthesiology | 1 Cooper Plaza, Anesthesiology Department, Camden, NJ 08103-1489 | 2008-05-19 |
| 1750572541 | Ghias Moussa Md | Anesthesiology | 1815 Kennedy Blvd, Jersey City, NJ 07305-2180 | 2007-08-06 |
| 1952515751 | Elizabeth Kay Riccobono | Anesthesiology | 65 W Jimmie Leeds Rd, Pomona, NJ 08240-9102 | 2007-05-10 |
| 1497870133 | Alexander Flaxman | Anesthesiology | 1930 Route 70 East, Suite N-70, Cherry Hill, NJ 08003-4203 | 2007-03-20 |
| Find all providers with the same taxonomy | ||||
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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.