JEANNETTE R RACKHAM (NPI# 1003878844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003878844 |
| Entity Type | Individual |
| Full Name | JEANNETTE R RACKHAM |
| Credential | PA |
| Practice Address |
1717 Main St Ste 5200 Dallas TX 75201-4612 |
| Mailing Address |
5551 Clay Ct Grand Prairie TX 75052-0705 |
| Practice Telephone | 2147122775 |
| Mailing Telephone | 2547027665 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2012-12-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA03203 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 181488102 | 05 | |
| TX | BLUE SHIELD | 8N9119 | 01 |
| Street Address |
1717 MAIN ST STE 5200 |
| City | DALLAS |
| State | TX |
| Zip Code | 75201-4612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710989348 | John Randall Lunde | Nurse Practitioner | 1717 Main St, Suite 5200, Dallas, TX 75201-4605 | 2005-08-12 |
| 1093085045 | Texas Em-1 Medical Services Pa | Nurse Practitioner | 1717 Main St, Suite#5200, Dallas, TX 75201-4612 | 2012-01-09 |
| 1497059034 | Blair Nicole Rose | Physician Assistant | 1717 Main St, 5200, Dallas, TX 75201-4612 | 2010-12-22 |
| 1871822353 | Jeremy Belschner | Nurse Practitioner | 1717 Main St, Suite 5200, Dallas, TX 75201-4612 | 2009-12-14 |
| 1265664601 | Ac Provider Services of Florida LLC | Anesthesiology | 1717 Main St, 5200, Dallas, TX 75201-4612 | 2009-08-19 |
| 1548494396 | Fox Creek Inpatient Services | Internal Medicine | 1717 Main St, Suite 5200, Dallas, TX 75201-4612 | 2009-05-08 |
| 1952578064 | Brian Kelly Blake | Emergency Medicine | 1717 Main St, Suite 5200, Dallas, TX 75201-4612 | 2008-05-08 |
| 1821284985 | Emcare Physician Providers Inc | Emergency Medicine | 1717 Main St, 5200, Dallas, TX 75201-4612 | 2007-09-21 |
| 1841490034 | Texas Em-i Medical Services, PC | Emergency Medicine | 1717 Main St, 5200, Dallas, TX 75201-4612 | 2007-07-25 |
| 1144421421 | Garry Francis Gagnon | Emergency Medicine | 1717 Main St, Suite 5200, Dallas, TX 75201-4612 | 2007-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255945564 | Amanda Michelle Flores | Physician Assistant | 1801 Young St, Dallas, TX 75201 | 2020-09-03 |
| 1992366488 | Anmd Health Pllc | Family Medicine | 1910 Pacific Ave Suite 15700, Dallas, TX 75201 | 2019-06-25 |
| 1972083772 | Randalls Food & Drugs Lp | Durable Medical Equipment & Medical Supplies | 2380 N Field St, Dallas, TX 75201 | 2018-08-21 |
| 1861986986 | Stella O Adebusoye | Registered Nurse | 2121 Main St Ste 100, Dallas, TX 75201 | 2018-06-21 |
| 1215432026 | Shawana Harris | Counselor | 1910 Pacific Ave #7024, Dallas, TX 75201 | 2018-03-26 |
| 1285150821 | Lauren Elisabeth Kelling | Nurse Practitioner | 700 N. Pearl St. Suiten208, Dallas, TX 75201 | 2017-08-15 |
| 1962932319 | Jade On | Dentist | 2225 N Harwood St, Dallas, TX 75201 | 2017-06-19 |
| 1053857268 | Lj Dentistry, Pllc | Dentist | 2100 Ross Ave #960, Dallas, TX 75201 | 2017-01-11 |
| 1770946444 | Robin Margolin | Counselor | 1919 Mckinney Ave # 2063, Dallas, TX 75201 | 2016-03-31 |
| 1750767448 | Hcf Web Services | Respite Care | 2320 Taylor St, 2322, Dallas, TX 75201 | 2015-08-04 |
| Find all providers in zip 75201 | ||||
| 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 |
|---|---|---|---|---|
| 1932700440 | Heather Weir | Physician Assistant | 7331 Gaston Ave Ste 180, Dallas, TX 75214-4131 | 2020-11-03 |
| 1225643562 | Yermiahu Levi Sarne | Physician Assistant | 6206 Preston Crest Ln, Dallas, TX 75230-1828 | 2020-09-14 |
| 1255945564 | Amanda Michelle Flores | Physician Assistant | 1801 Young St, Dallas, TX 75201 | 2020-09-03 |
| 1275151102 | Kelly Ashworth | Physician Assistant | 7331 Gaston Ave # 180, Dallas, TX 75214-4131 | 2020-07-07 |
| 1780201715 | Gabriela Yvonne Camacho | Physician Assistant | 7331 Gaston Ave Unit 180, Dallas, TX 75214-4131 | 2020-06-25 |
| 1346879699 | Ws Neuroassist, Pllc | Physician Assistant | 7324 Gaston Ave Ste 124-80, Dallas, TX 75214-6126 | 2020-04-07 |
| 1265065122 | Sarah Bell Stewart | Physician Assistant | 7811 Bryn Mawr Dr, Dallas, TX 75225-8217 | 2020-02-19 |
| 1093348237 | Meagan Lee Barry | Physician Assistant | 221 W Colorado Blvd Ste 431, Dallas, TX 75208-2312 | 2020-02-17 |
| 1245863554 | Melissa Ann Johnston | Physician Assistant | 4373 Boca Bay Dr, Dallas, TX 75244-7408 | 2020-02-14 |
| 1205479607 | Mj Surgical, Pllc | Physician Assistant | 1408 N Riverfront Blvd # 906, Dallas, TX 75207-3912 | 2019-10-18 |
| Find all providers in DALLAS | ||||
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| 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.