CLARK JACKSON (NPI# 1053768945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053768945 |
| Entity Type | Individual |
| Full Name | CLARK JACKSON |
| Practice Address |
2500 S 60th St Apt 21 Lincoln NE 68506-3579 |
| Practice Telephone | 4026132633 |
| Mailing Telephone | 4026132633 |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2016-05-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 70693 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962508192 | Clark Kent Jackson | Social Worker | 6 S 2nd St, Ste 918, Yakima, WA 98901-2632 | 2006-09-15 |
| Street Address |
2500 S 60TH ST APT 21 |
| City | LINCOLN |
| State | NE |
| Zip Code | 68506-3579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265058861 | Christine Ruth Bergman | Dentist | 2121 S 70th Street, Lincoln, NE 68506 | 2020-06-19 |
| 1881218428 | South Lincoln Family Dentistry LLC | Dentist | 2121 S. 70th Street, Lincoln, NE 68506 | 2020-05-29 |
| 1982235883 | Dermatology Associates of Lincoln, LLC | Dermatology | 6969 South Street, Lincoln, NE 68506 | 2020-01-29 |
| 1609343052 | Advanced Medical Imaging Surgery Center, LLC | Clinic/Center | 7555 Pioneers Blvd, Lincoln, NE 68506 | 2018-10-24 |
| 1912484064 | Knaub Counseling Services, Inc. | Counselor | 1919 S 40th St Ste 312, Lincoln, NE 68506 | 2018-07-22 |
| 1073004586 | Navigate LLC | Clinic/Center | 4535 Normal Blvd Ste 142, Lincoln, NE 68506 | 2018-05-21 |
| 1346761053 | Ewonubari Kehinde Erekere Kats | Registered Nurse | 1500 S. 70th Street, 104, Lincoln, NE 68506 | 2017-07-03 |
| 1871013300 | Jennifer N Miller | Registered Nurse | 1500 S 48th Street, Suite 800, Lincoln, NE 68506 | 2017-06-26 |
| 1407393143 | Samantha Wilson | Specialist/Technologist | 1900 Broadmoore Drive, Lincoln, NE 68506 | 2017-01-19 |
| 1588119283 | Doctors Outpatient Surgery Center | Clinic/Center | 5055 A St, Suite 100, Lincoln, NE 68506 | 2016-08-23 |
| Find all providers in zip 68506 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699123976 | Walross Jim Basit | Nurse Anesthetist, Certified Registered | 4544 Bancroft Ave Apt 4, Lincoln, NE 68506-4272 | 2016-05-27 |
| 1922345636 | Lime Rock Medical Inc. | Nurse Anesthetist, Certified Registered | 25 Southwick Dr, Lincoln, RI 02865-4821 | 2013-01-15 |
| 1093051989 | Carl C Blackwood | Nurse Anesthetist, Certified Registered | 5701 Lillibridge St Apt 10, Lincoln, NE 68506-3543 | 2012-12-20 |
| 1003973918 | Matthew C. Oliver | Nurse Anesthetist, Certified Registered | 6911 Van Dorn St Ste 2, Lincoln, NE 68506-6801 | 2007-01-02 |
| 1487745840 | Michael Paul Audette | Nurse Anesthetist, Certified Registered | 17 E Butterfly Way, Lincoln, RI 02865-3935 | 2006-09-28 |
| 1992751838 | Caroline E Breznyak | Nurse Anesthetist, Certified Registered | Transalpine Dr, Lincoln, ME 04457 | 2006-05-25 |
| 1992772453 | Michael D. Lawler | Nurse Anesthetist, Certified Registered | 2531 Marilynn Ave, Lincoln, NE 68502 | 2006-03-03 |
| 1396712154 | Cammi L Fitch | Nurse Anesthetist, Certified Registered | 575 S 70th St Ste 305, Lincoln, NE 68510 | 2006-03-01 |
| 1659346740 | Keith E Macksoud | Nurse Anesthetist, Certified Registered | 1817 Old Louisquisset Pike, Lincoln, RI 02865-4516 | 2006-02-22 |
| 1215930433 | Jay Alan Sveen | Nurse Anesthetist, Certified Registered | 1710 S 70th St, Ste 200, Lincoln, NE 68506-1677 | 2005-05-23 |
| Find all providers in LINCOLN | ||||
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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.