Kimberly Jackson (NPI# 1447536370, PAC ID# 3870711526) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1447536370 |
| PAC ID by PECOS | 3870711526 |
| Professional Enrollment ID | I20140821002469 |
| Full Name | Kimberly Jackson |
| Organization Legal Name | 4M EMERGENCY SYSTEMS TOD LLC |
| Address |
1296 Tod Nwpl Suite 200 Warren OH 44485-2474 |
| Phone Number | 2406862300 |
| Gender | F |
| Medical School | OHIO UNIVERSITY OF OSTEO MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 3173547593 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360096 | EAST LIVERPOOL CITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 15655 State Route 170, Suite H, East Liverpool, OH 43920-9672 | 3309320183 | RIVER VALLEY PHYSICIANS LLC |
| 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 | 2406862300 | 4M EMERGENCY SYSTEMS TOD LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_EP_1 | e-Prescribing | 85% | |
| ACI_EC_TRANS_PEA_1 | Provide Patient Access | 84% | |
| ACI_EC_TRANS_PEA_2 | View, Download, or Transmit (VDT) | 18% | |
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PSE_1 | Patient-Specific Education | 87% | |
| ACI_EC_TRANS_SM_1 | Secure Messaging | 45% |
| Organization Legal Name | 4M EMERGENCY SYSTEMS TOD LLC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Maria Christine Sember | Emergency Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| Glenn W Ray | Family Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| Matthew Eggleston | Emergency Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| John M Manenti | Family Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| John L Baumeier | Emergency Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| Asheesh A Pai-dhungat | Emergency Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| Street Address |
1296 TOD NWPL SUITE 200 |
| City | WARREN |
| State | OH |
| Zip | 44485-2474 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Maria Christine Sember | Emergency Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| Glenn W Ray | Family Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| Matthew Eggleston | Emergency Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| John M Manenti | Family Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| John L Baumeier | Emergency Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| Asheesh A Pai-dhungat | Emergency Medicine | 4m Emergency Systems Tod LLC | 1296 Tod Nwpl, Suite 200, Warren, OH 44485-2474 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristin Elaine Boyd | Nurse Practitioner | S and J Med Inc | 2760 Parkman Rd Nw, Warren, OH 44485-1699 |
| Paresh G Mehta | Obstetrics/gynecology | 2390 Parkman Rd Nw, Warren, OH 44485-1774 | |
| Walter E Scott Iii | Family Practice | Mercy Health Physicians Youngstown, LLC | 1296 Tod Pl Nw, Warren, OH 44485-2474 |
| Sharon Laverne George | Family Medicine | 420 Southern Blvd Nw, Warren, OH 44485-2537 | |
| Anna H Grzebieniak | Nurse Practitioner | Compass Family and Community Services | 3120 W Market St, Warren, OH 44485-3069 |
| John Michael Jerome | Nurse Practitioner | Ohio North East Health Systems Inc | 716 Tod Ave Sw, Warren, OH 44485-3608 |
| Justin Pykare | Nurse Practitioner | Ohio North East Health Systems Inc | 716 Tod Ave Sw, Warren, OH 44485-3608 |
| City | WARREN |
| Zip Code | 44485 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | WARREN + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Kimberly Jackson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.