JEFFREY D JACKSON (NPI# 1033123179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033123179 |
| Entity Type | Individual |
| Full Name | JEFFREY D JACKSON |
| Credential | MD |
| Practice Address |
1160 E 3900 S Ste 5000 Salt Lake City UT 84124-1275 |
| Mailing Address |
Po Box 100253 Atlanta GA 30384-0253 |
| Practice Telephone | 8012617479 |
| Practice Fax Number | 8012617429 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 48648 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 797903000 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1160 E 3900 S Ste 4050, Salt Lake City, UT 841241264 | 8012628486 | 8012617429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578193181 | Jeffrey Jackson | Student in an Organized Health Care Education/Training Program | 1055 W Longfellow Dr, Manteno, IL 60950-9472 | 2020-01-22 |
| 1881259570 | Jeffrey Lamar Jackson II | Chiropractor | 13865 S Dixie Hwy # 307, Miami, FL 33176-7221 | 2019-05-08 |
| 1548753965 | Jeffrey Jackson | Social Worker | 2024 Corporate Centre Dr Ste 103, Myrtle Beach, SC 29577-7410 | 2018-06-11 |
| 1154792422 | Jeffrey Scott Jackson | Occupational Therapy Assistant | 3209 Bristol Hwy., Nhc Healthcare, Johnson City, TN 37601 | 2015-10-13 |
| 1447481205 | Jeffrey Brown Jackson | Marriage & Family Therapist | 450 N University Ave, Suite 204, Provo, UT 84601-2860 | 2009-07-28 |
| 1952421927 | Jeffrey W Jackson | Pharmacist | 5510 Lafayette Rd Ste 260, Indianapolis, IN 46254-1691 | 2007-03-30 |
| 1659432607 | Jeffrey L Jackson | Internal Medicine | 500o W National Ave, Milwaukee, WI 53295-0001 | 2006-12-13 |
| 1760589477 | Jeffrey Scott Jackson | Pharmacist | 16821 Rosman Hwy, Lake Toxaway, NC 28747-9593 | 2006-09-17 |
| 1194764860 | Jeffrey Kline Jackson | Family Medicine | 2200 W Touhy Ave, Chicago, IL 60645-3412 | 2006-06-06 |
| 1972563443 | Jeffrey A Jackson | Internal Medicine | 720 Eskenzi Ave., Indianapolis, IN 46202-5166 | 2006-03-27 |
| Street Address |
1160 E 3900 S STE 5000 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84124-1275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487646998 | Robert B Bourne | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2005-08-19 |
| 1407407679 | Francisco Jose Hurtado Iv | Physician Assistant | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2019-09-27 |
| 1578118659 | Robert Derrel Johnstun | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2019-08-06 |
| 1508424870 | Alex Ann Anderson | Physical Therapist | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2019-06-03 |
| 1811488976 | Alexa Victoria Nickel | Registered Nurse | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2018-05-24 |
| 1679002190 | Chase Naylor | Physician Assistant | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2017-06-08 |
| 1063764629 | Craig Robert Schumann | Physician Assistant | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2012-10-08 |
| 1700149572 | Oliver Brant Nikolaus | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2012-06-18 |
| 1992859524 | David P Stefl | Physician Assistant | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2007-01-22 |
| 1275576274 | Tony Landon Miller | Physician Assistant | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2006-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
| 1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
| 1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
| 1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
| 1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
| 1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
| 1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
| 1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
| 1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
| 1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
| Find all providers in zip 84124 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144582354 | Daniel Bradley Gibbs | Orthopaedic Surgery | 6360 S 3000 E # Sre210, Salt Lake City, UT 84121 | 2012-06-13 |
| 1992037410 | Geoffrey Alvin Orme | Orthopaedic Surgery | 2045 E 900 S, Salt Lake City, UT 84108-1301 | 2010-02-09 |
| 1700050044 | Junius Clawson Md PC | Orthopaedic Surgery | 5810 S 300 E Ste 300, Salt Lake City, UT 84107-8176 | 2008-04-17 |
| 1376764282 | Joan D Miles | Orthopaedic Surgery | 5169 S Cottonwood St Ste 430, Salt Lake City, UT 84107-6774 | 2007-05-01 |
| 1407988504 | Johnathan Horne | Orthopaedic Surgery | 6362 Vintage Oak Ln, Salt Lake City, UT 84121-6544 | 2007-03-12 |
| 1578606562 | Craig Hugh Mcqueen | Orthopaedic Surgery | 1250 E 3900 S Ste 4050, Salt Lake City, UT 84124-1348 | 2007-02-15 |
| 1548351364 | John F Bermen Jr. | Orthopaedic Surgery | 3465 S 4155 West, Suite 5, Salt Lake City, UT 84120-2013 | 2006-09-27 |
| 1669563706 | Utah Bone & Joint Center Lc | Orthopaedic Surgery | 5323 S. Woodrow St, Ste 202, Salt Lake City, UT 84107 | 2006-09-27 |
| 1255378063 | Kent Mitchell Samuelson | Orthopaedic Surgery | 324 10th Avenue, #100, Salt Lake City, UT 84103 | 2006-06-01 |
| 1104881499 | Jacques L. D'astous | Orthopaedic Surgery | Fairfax Road At Virginia Street, Shriners Hospitals for Children, Salt Lake City, UT 84103-4399 | 2006-04-19 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84124 |
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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.