MS. DIANNE REGINA JACKSON (NPI# 1003193947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003193947 |
| Entity Type | Individual |
| Full Name | MS. DIANNE REGINA JACKSON |
| Credential | M.D. |
| Practice Address |
9601 Reistertown Rd Owings Mills MD 21117 |
| Mailing Address |
P.o. Box (561) Lanham MD 20703 |
| Practice Telephone | 3013529763 |
| Mailing Telephone | 3013529763 |
| Enumeration Date | 2011-11-07 |
| Last Update Date | 2011-11-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | D0039496 | MD | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245741800 | Dianne Jackson | Registered Nurse | 1035 Hunters Creek Dr, Desoto, TX 75115-4712 | 2017-10-22 |
| 1922070655 | Dianne Jackson | Nurse Practitioner | 5250 New Jersey Ave, Fort Dix, NJ 08640-5017 | 2006-02-06 |
| 1255314787 | Dianne Ruth Jackson | Physical Therapist | 1001 Blythe Blvd, Suite 200, Charlotte, NC 28203-5863 | 2005-11-29 |
| Street Address |
9601 REISTERTOWN RD |
| City | OWINGS MILLS |
| State | MD |
| Zip Code | 21117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699303727 | Modern Medicine Express Care | Clinic/Center | 1041 Campbell Meadow Rd, Owings Mills, MD 21117 | 2020-04-01 |
| 1679111892 | Abria Therapy, LLC | Behavioral Analyst | 10451 Mill Run Circle, Suite 400, Owings Mills, MD 21117 | 2019-12-18 |
| 1194384917 | Michele Dawson Overtoom | Pharmacist | Wegmans Pharmacy #125, 10100 Reisterstown Road, Owings Mills, MD 21117 | 2019-06-06 |
| 1033675897 | Grace Residential Services, LLC | Clinic/Center | 4117 Brookside Oaks Road, Owings Mills, MD 21117 | 2019-02-18 |
| 1801373246 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 10270 Mill Run Circle, Owings Mills, MD 21117 | 2018-07-27 |
| 1922513167 | Vamsh Health Services, LLC | Pharmacy | 10309 Grand Central Ave Ste 110, Owings Mills, MD 21117 | 2017-12-11 |
| 1215456652 | Safari Healthcare | Home Health | 4129 Brookside Oak Road, Owings Mills, MD 21117 | 2017-09-18 |
| 1639697964 | Rachel Tova Goldberg | Behavioral Analyst | 11907 Hunting Tweed Dr., Owings Mills, MD 21117 | 2017-09-07 |
| 1528599149 | Nest Home Care, LLC | In Home Supportive Care | 90 Painters Mill Rd Ste 223, Owings Mills, MD 21117 | 2017-03-24 |
| 1508221243 | Quality Home Care, LLC | In Home Supportive Care | 124 Embleton Road, Owings Mills, MD 21117 | 2015-12-23 |
| Find all providers in zip 21117 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490950 | Arlene Elizabeth George | General Practice | 1500 W Perimeter Rd Ste 4350, Jb Andrews, MD 20762-6604 | 2020-09-04 |
| 1891303038 | Lorenzo Leggio | General Practice | Nih/nida, Bayview Campus, Brc, 251 Bayview Boulevard, Room 01a844, Baltimore, MD 21224 | 2020-07-14 |
| 1548889447 | Canary Doctor LLC | General Practice | 8904 Maxwell Dr, Potomac, MD 20854-3124 | 2020-04-10 |
| 1083247894 | Medstar Medical Group II LLC | General Practice | 9101 Franklin Square Drive, Ste 200, Medical Arts Building, Baltimore, MD 21237-4072 | 2020-02-20 |
| 1881239838 | Avicention LLC | General Practice | 350c Fortune Ter # 227, Potomac, MD 20854-2980 | 2019-11-14 |
| 1972148963 | My Primary Care | General Practice | 826 Washington Rd Ste 110, Westminster, MD 21157-5779 | 2019-11-13 |
| 1619512837 | David Newsome | General Practice | 12305 Sandalwood Lane, Silver Spring, MD 20904 | 2019-11-12 |
| 1720623242 | Assured Access Medical Associates Inc. | General Practice | 7221 Hanover Pkwy Ste C, Greenbelt, MD 20770-2022 | 2019-11-07 |
| 1780240671 | Capstone Treatment Center, Inc | General Practice | 1133 E West Hwy Apt 204e, Silver Spring, MD 20910-4804 | 2019-05-15 |
| 1861058935 | Revive Treatment Center Inc | General Practice | 1133 E West Hwy Apt 1515w, Silver Spring, MD 20910-6833 | 2019-05-14 |
| Find all providers with the same taxonomy | ||||
| City | OWINGS MILLS |
| Zip Code | 21117 |
Please comment or provide details below to improve the information on MS. DIANNE REGINA 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.