PATRICK JACKSON (NPI# 1962968560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962968560 |
| Entity Type | Individual |
| Full Name | PATRICK JACKSON |
| Credential | RBT |
| Practice Address |
918 Eisenhower Dr Rock Springs WY 82901-4449 |
| Practice Telephone | 3073991793 |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-02-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-19-78853. | WY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295341097 | Patrick Dale Jackson | Pharmacist | 19300 S Hamilton Ave Ste 170-180, Gardena, CA 90248-4400 | 2020-09-17 |
| 1871141457 | Patrick Dior Jackson | Counselor | 5111 S 3rd St, Louisville, KY 40214-2601 | 2019-08-28 |
| 1427273713 | Patrick Louis Jackson Sr. | Durable Medical Equipment & Medical Supplies | 58110 W W Harleaux St, Plaquemine, LA 70764-3230 | 2007-04-13 |
| 1093253833 | Patrick Jackson | Chiropractor | 630 National Hwy, Thomasville, NC 27360-2601 | 2017-02-01 |
| 1629414701 | Patrick Jackson | Emergency Medicine | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2013-05-16 |
| 1548587835 | Patrick E Jackson | Internal Medicine | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2010-04-26 |
| 1619062908 | Patrick Jackson | Dentist | 16 Washington St, Toms River, NJ 08753-7643 | 2006-10-04 |
| 1508865940 | Patrick Jackson | Surgery | 3800 Reservoir Rd Nw, Washington, DC 20007-2113 | 2005-07-19 |
| Street Address |
918 EISENHOWER DR |
| City | ROCK SPRINGS |
| State | WY |
| Zip Code | 82901-4449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568094043 | Carol Mary Iverson | Naturopath | 120 Winston Dr., Ste. 101, Rock Springs, WY 82901 | 2020-02-12 |
| 1366098691 | Nolan Jeffres | Dentist | 1151 Gateway Blvd, Suite 102, Rock Springs, WY 82901 | 2019-08-13 |
| 1588149181 | Ali Pendleton | Case Manager/Care Coordinator | 79 Winston #235, Rock Springs, WY 82901 | 2018-09-28 |
| 1982142014 | Tammy Fausett | Speech-Language Pathologist | 1105 Applewood Drive, Rock Springs, WY 82901 | 2017-02-09 |
| 1649713983 | Lori Lee Cunningham | Case Manager/Care Coordinator | 325 Archers Trl, Rock Springs, WY 82901 | 2016-11-18 |
| 1841664505 | Theresa Morrison | Case Manager/Care Coordinator | 308 Peak Road, Rock Springs, WY 82901 | 2015-11-18 |
| 1811376478 | Aspen Mountain Medical Center LLC | General Acute Care Hospital | 4401 College Ave, Rock Springs, WY 82901 | 2015-05-28 |
| 1487931416 | Stephanie Lee Dupree | Nurse Practitioner | 1204 Hilltop Dr. #107 & #108, Rock Springs, WY 82901 | 2011-11-04 |
| 1114201845 | Cowboy Urgent Care, Inc | General Practice | 1453-a Dewar Drive, Rock Springs, WY 82901 | 2011-09-29 |
| 1649564931 | Guardian Flight Inc | Ambulance | 1208 Hilltop Drive, Suite 203, Rock Springs, WY 82901 | 2011-06-03 |
| Find all providers in zip 82901 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962066670 | Ruthanne Grajeda | Behavior Technician | 2632 Foothill Blvd Ste 205, Rock Springs, WY 82901-4758 | 2019-04-28 |
| 1699389965 | Billie-nicole Boehm | Behavior Technician | 2632 Foothill Blvd Ste 205, Rock Springs, WY 82901-4758 | 2020-09-03 |
| 1245848001 | Jessie Lockwood Willoughby | Behavior Technician | 2632 Foothill Blvd, Rock Springs, WY 82901-4756 | 2020-07-17 |
| 1154945400 | Ashten Zuehlsdorff | Behavior Technician | 2632 Foothill Blvd, Rock Springs, WY 82901-4756 | 2020-06-02 |
| 1992343941 | Kyrstin King | Behavior Technician | 2632 Foothill Blvd Ste 205, Rock Springs, WY 82901-4758 | 2019-12-19 |
| 1558903625 | Kaila Krotzer | Behavior Technician | 2632 Foothill Blvd Ste 205, Rock Springs, WY 82901-4758 | 2019-10-10 |
| 1780243477 | Geannie Berg | Behavior Technician | 2632 Foothill Blvd Ste 205, Rock Springs, WY 82901-4758 | 2019-06-06 |
| 1053978635 | Patty Schoenewald | Behavior Technician | 2632 Foothill Blvd Ste 205, Rock Springs, WY 82901-4758 | 2019-05-20 |
| 1982269825 | Rhonda Hood | Behavior Technician | 2632 Foothill Blvd Ste 205, Rock Springs, WY 82901-4758 | 2019-05-06 |
| 1689173288 | Jessica Ellen Freeman | Behavior Technician | 813 West St, Rock Springs, WY 82901-5949 | 2018-02-08 |
| Find all providers in ROCK SPRINGS | ||||
| City | ROCK SPRINGS |
| Zip Code | 82901 |
Please comment or provide details below to improve the information on PATRICK 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.