Gloria Jackson (NPI# 1235123423, PAC ID# 5698715639) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1235123423 |
| PAC ID by PECOS | 5698715639 |
| Professional Enrollment ID | I20050509000878 |
| Full Name | Gloria Jackson |
| Organization Legal Name | TIDEWATER PHYSICIANS MULTISPECIALTY GROUP, PC |
| Address |
101 A York Crossing Grafton VA 23692 |
| Phone Number | 7578987737 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE |
| Graduation Year | 1986 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 2860398526 |
| Number of Group Practice Members | 231 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490093 | SENTARA CAREPLEX HOSPITAL |
| 490052 | RIVERSIDE REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 101 A York Crossing, Grafton, VA 23692 | 7578987737 | TIDEWATER PHYSICIANS MULTISPECIALTY GROUP, PC |
| Organization Legal Name | TIDEWATER PHYSICIANS MULTISPECIALTY GROUP, PC |
| Physicians | 240 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Zelinskas | Family Medicine | Tidewater Physicians Multispecialty Group, PC | 1016 Justis St, Chesapeake, VA 23325-2516 |
| Danae Consuelo Guerra | Physician Assistant | Tidewater Physicians Multispecialty Group, PC | 1100 Volvo Pkwy, Suite 100, Chesapeake, VA 23320-3341 |
| Jennifer Ann Vannoy | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 5399 Old Virginia St, Urbanna, VA 23175-2179 |
| Trina S Williams | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 11751 Rock Landing Dr, Suite 1, Newport News, VA 23606-4233 |
| Stephanie Barnes | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 222 Grafton Dr, Grafton, VA 23692-2152 |
| Latoya Shant'e Kearney | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 1405 Kiln Creek Pkwy K, Newport News, VA 23602-9700 |
| Laurie Harris | Family Medicine | Tidewater Physicians Multispecialty Group, PC | 2117 Hartford Rd, Hampton, VA 23666-2408 |
| Jeffrey Harris | Family Medicine | Tidewater Physicians Multispecialty Group, PC | 307 Cook Rd, Yorktown, VA 23690-9640 |
| Pamala Suter | Registered Dietitian Or Nutrition Professional | Tidewater Physicians Multispecialty Group, PC | 132 Professional Cir, Williamsburg, VA 23185-3374 |
| David Deeley | Family Medicine | Tidewater Physicians Multispecialty Group, PC | 12655 Warwick Blvd A, Newport News, VA 23606-2501 |
| Street Address |
101 A YORK CROSSING |
| City | GRAFTON |
| State | VA |
| Zip | 23692 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Meghan Pollard | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 101 A York Crossing, Grafton, VA 23692 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lisa M Perez | Clinical Social Worker | Colonial Behavioral Health | 3804 George Washington Memorial Hwy, Yorktown, VA 23692 |
| Laura Bronstein | Clinical Social Worker | Hampton Roads Counseling Ctr Inc | 6515 Rt, Suite 17, Grafton, VA 23692-1069 |
| Gary Lee Baker | Clinical Social Worker | Hampton Roads Counseling Ctr Inc | 6515 Rt, Suite 17, Grafton, VA 23692-1069 |
| Catherine D Smithson | Clinical Social Worker | Hampton Roads Counseling Ctr Inc | 6515 Rt, Suite 17, Grafton, VA 23692-1069 |
| Stephanie Barnes | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 222 Grafton Dr, Grafton, VA 23692-2152 |
| Samuel Holloway | Physician Assistant | Tidewater Physicians Multispecialty Grp, PC | 222 Grafton Dr, Grafton, VA 23692-2152 |
| William J Shields | Dermatology | W J Shields M D | 914 Denbigh Blvd, Grafton, VA 23692-2156 |
| Lois W Shields | Nurse Practitioner | W J Shields M D | 914 Denbigh Blvd, Grafton, VA 23692-2156 |
| Kelly Neidiffer Bailey | Optometry | Zoe Inc. | 6515 George Washington Mem Hwy, Suite 102, Yorktown, VA 23692-2182 |
| Brenton L Burchett | Chiropractic | Gunderman Chiropractic and Wellness LLC | 5701 George Washington Mem Hwy, Yorktown, VA 23692-2773 |
| Find all physicians in zip 23692 | |||
| City | GRAFTON |
| Zip Code | 23692 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | GRAFTON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Gloria 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.