CLAUDETTE F JACKSON (NPI# 1962494450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962494450 |
| Entity Type | Individual |
| Full Name | CLAUDETTE F JACKSON |
| Credential | PAC |
| Practice Address |
105 Crescent Ave Louisville KY 40206-1525 |
| Mailing Address |
3507 Lennox View Ct Unit 208 Louisville KY 40299-7311 |
| Practice Telephone | 5023279100 |
| Practice Fax Number | 5027423767 |
| Mailing Telephone | 5024173908 |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2014-02-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA902 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | BCBS | 000000595343 | 01 |
| KY | RAILROAD MEDICARE | P00706704 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669781266 | Claudette Sheray Jackson | Home Health Aide | 6890 Laird Ave, Reynoldsburg, OH 43068-2422 | 2010-09-29 |
| Street Address |
105 CRESCENT AVE |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40206-1525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932484862 | Lorri Livers Houck, Pllc | Clinic/Center | 105 Crescent Ave, Louisville, KY 40206-1525 | 2011-10-11 |
| 1831487784 | Kentuckiana Mental Health Associates | Psychiatry & Neurology | 105 Crescent Ave, Louisville, KY 40206-1525 | 2011-07-13 |
| 1285716522 | David Lynn Hockensmith | Internal Medicine | 105 Crescent Ave, Louisville, KY 40206-1525 | 2006-10-19 |
| 1578576690 | Md2u Pllc | Clinic/Center | 105 Crescent Ave, Louisville, KY 40206-1525 | 2006-08-14 |
| 1780643726 | Peter Michael Steiner | Psychiatry & Neurology | 105 Crescent Ave, Louisville, KY 40206-1525 | 2006-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285243477 | Stephanie Atherton | Nurse Practitioner | 1623 Story Ave, Louisville, KY 40206 | 2020-07-24 |
| 1023547460 | Jeffrey Obiora | Student in an Organized Health Care Education/Training Program | 500 South Preston St, Room 305, Lousiville, KY 40206 | 2017-06-08 |
| 1053840710 | Mary Oliver Humke | Lactation Consultant, Non-RN | 155 N Galt Ave, Louisville, KY 40206 | 2017-06-07 |
| 1417304908 | James Edward Meffert Sr. | Dentist | 1618 Story Ave. (home/office Setting), Louisville, KY 40206 | 2016-05-16 |
| 1235516527 | Jara Nashelle Vega Velez | Internal Medicine | 800 Zorn Ave Dept Of, Louisville, KY 40206 | 2015-05-06 |
| 1184058885 | Reba D Ziller | Occupational Therapist | 4604 Lowe Road, Regis Woods Rehab Center, Louisville, KY 40206 | 2013-08-29 |
| 1407109176 | Jessica L Hoback | Physical Therapy Assistant | 2141 Sycamore Avenue, Louisville, KY 40206 | 2012-10-18 |
| 1598039315 | Mary Barbara Sowers | Emergency Medicine | 611 Emery Rd, Louisville, KY 40206 | 2012-02-24 |
| 1053628479 | Adrian J Pellegrini Md | Nurse Practitioner | 170 Crescent Ave, Louisville, KY 40206 | 2010-09-07 |
| 1518297761 | Kiley Nontell Mcneill | Behavioral Analyst | 1100 East Market St., Louisville, KY 40206 | 2010-01-12 |
| Find all providers in zip 40206 | ||||
| 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 |
|---|---|---|---|---|
| 1184225591 | Alexis Garrett | Physician Assistant | 16993 Green Crest Ln, Louisville, KY 40245-3217 | 2020-11-03 |
| 1164033353 | Tyler Roberts | Physician Assistant | Private, Louisville, KY 40241 | 2020-08-12 |
| 1184247231 | Jeremiah Noe | Physician Assistant | 3999 Dutchmans Ln Ste 2e, Louisville, KY 40207-4748 | 2020-05-23 |
| 1598388894 | Amanda Marie Hafner | Physician Assistant | 200 E Chestnut St Bldg Suite300, Louisville, KY 40202-1831 | 2020-05-20 |
| 1205487170 | Kenneth D Morrison | Physician Assistant | 9300 Stonestreet Rd Ste 200, Louisville, KY 40272-2894 | 2019-09-23 |
| 1518515444 | William Wilson | Physician Assistant | 1037 E Caldwell St, Louisville, KY 40204-1857 | 2019-09-04 |
| 1760955546 | Benjamin Charles Askins | Physician Assistant | 7906 New La Grange Rd, Louisville, KY 40222-4718 | 2019-01-04 |
| 1770066292 | Molly Roberson Comprehensive Surgical Assistance Pllc | Physician Assistant | 1064 Eastern Pkwy, Louisville, KY 40217-1532 | 2018-09-11 |
| 1598246860 | Kelsi J Barnes | Physician Assistant | 13151 Magisterial Dr # 200, Louisville, KY 40223-4103 | 2018-08-24 |
| 1174009930 | Faun Ellwood-digel | Physician Assistant | 275 W Walnut St, Louisville, CO 80027-2295 | 2018-07-16 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40206 |
Please comment or provide details below to improve the information on CLAUDETTE F JACKSON.
| 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.