VICTORIA RENEE JACKSON (NPI# 1053970426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053970426 |
| Entity Type | Individual |
| Full Name | VICTORIA RENEE JACKSON |
| Credential | DO |
| Practice Address |
1423 N Jefferson Ave # B100 Springfield MO 65802-1917 |
| Practice Telephone | 4172698817 |
| Practice Fax Number | 4172698744 |
| Mailing Telephone | 4172698817 |
| Mailing Fax Number | 4172698744 |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-06-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2019018906 | MO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386253086 | Victoria Jackson | Social Worker | 5133 Carson Allen Rd, Hope Mills, NC 28348-9399 | 2020-07-28 |
| 1992005060 | Victoria Elaine Jackson | Licensed Practical Nurse | 1501 Euclid Ave, Syracuse, NY 13224-1940 | 2010-10-23 |
| 1194901934 | Victoria Lynn Jackson | Speech-Language Pathologist | 7315 Roaring Springs Dr, Austin, TX 78736-3319 | 2008-01-10 |
| 1316558083 | Victoria Grace Jackson | Pharmacist | 844 W Fremont St, Galesburg, IL 61401-2509 | 2020-08-14 |
| 1265092415 | Victoria Jackson | Home Health Aide | 1771 E Flamingo Rd, Las Vegas, NV 89119-5155 | 2019-06-19 |
| 1518435437 | Victoria Lynn Jackson | Registered Nurse | 4860 Y St Ste 200, Sacramento, CA 95817-2309 | 2018-11-08 |
| 1023502515 | Victoria F Jackson | Behavior Technician | 765 Pierce Dr, Columbus, OH 43223-2425 | 2018-06-18 |
| 1225569536 | Victoria Jackson | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2017-03-27 |
| 1679984108 | Victoria Cassandra Jackson | Social Worker | 10532 N Port Washington Rd, Mequon, WI 53092 | 2014-05-19 |
| 1386957553 | Victoria Elizabeth Jackson | Licensed Practical Nurse | 2354 Christopher Pl, Tallahassee, FL 32308-4109 | 2010-07-16 |
| Street Address |
1423 N JEFFERSON AVE # B100 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65802-1917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467654715 | Joseph William Barnard | Family Medicine | 1423 N Jefferson Ave # B100, Springfield, MO 65802 | 2007-05-31 |
| 1124648654 | Joshua Etchson | Family Medicine | 1423 N Jefferson Ave # B100, Springfield, MO 65802-1917 | 2020-04-24 |
| 1366071540 | Elizabeth Jordan Moore | Family Medicine | 1423 N Jefferson Ave # B100, Springfield, MO 65802-1917 | 2020-04-08 |
| 1780213181 | Nichole Norgard | Family Medicine | 1423 N Jefferson Ave # B100, Springfield, MO 65802-1917 | 2020-04-07 |
| 1770112385 | John Duncan Tillack | Family Medicine | 1423 N Jefferson Ave # B100, Springfield, MO 65802-1917 | 2020-04-06 |
| 1487283990 | Brittany Nicole Dahlager | Family Medicine | 1423 N Jefferson Ave # B100, Springfield, MO 65802-1917 | 2020-04-06 |
| 1790314383 | Sara Kristine Christianson | Family Medicine | 1423 N Jefferson Ave # B100, Springfield, MO 65802-1917 | 2020-04-06 |
| 1568091189 | Grant Ralston | Student in an Organized Health Care Education/Training Program | 1423 N Jefferson Ave # B100, Springfield, MO 65802-1917 | 2020-04-06 |
| 1689203200 | Alexandra Jones | Student in an Organized Health Care Education/Training Program | 1423 N Jefferson Ave # B100, Springfield, MO 65802-1917 | 2020-04-06 |
| 1174184931 | Jacob Allen Bolt | Family Medicine | 1423 N Jefferson Ave # B100, Springfield, MO 65802-1917 | 2019-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454549 | Andrea Strauch | Counselor | 2024 W Chestnut Expressway Way, Springfield, MO 65802 | 2020-10-12 |
| 1962968867 | Chad Michael Linck | Specialist/Technologist | 2125 N Glenstone Ave, Springfield, MO 65802 | 2019-02-15 |
| 1790254647 | Meds To Live By | Pharmacist | 1134 N. Scarlett Way, Springfield, MO 65802 | 2018-11-21 |
| 1568945103 | Ficom | Non-Pharmacy Dispensing Site | 1308 North Glenstone Avenue, Springfield, MO 65802 | 2018-09-10 |
| 1982194775 | Karla Caballero | Marriage & Family Therapist | 8627 Montant Fort Way, 145, Sprinfield, MO 65802 | 2018-05-16 |
| 1780191809 | Tiffany Chawntay Coryell | Pharmacist | 1134 North Scarlett Way, Springfield, MO 65802 | 2018-01-10 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1407389596 | Medical Mile Imaging | Radiology | 3905 E Windsmore Dr, Springfield, MO 65802 | 2017-04-06 |
| 1346619103 | Jill A Knight | Occupational Therapist | 1601 E. Pythian, Green Valley State School, Springfield, MO 65802 | 2015-09-22 |
| 1447653258 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3720 E Sunshine St, Springfield, MO 65802 | 2014-10-07 |
| Find all providers in zip 65802 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
| 1649815796 | 180 Health Lifestyle Wellness Centers | Family Medicine | 1936 S Glenstone Ave, Springfield, MO 65804-2305 | 2019-11-13 |
| 1790337988 | Aminat Ogun | Family Medicine | 520 N 4th St # 62702, Springfield, IL 62702-5238 | 2019-07-09 |
| 1770076622 | Thomas John Schumann | Family Medicine | 1260 E. Woodlawn Ave, Suite 200, Springfield, PA 19064-3988 | 2018-06-14 |
| 1134648959 | Patricia Derges | Family Medicine | 3259 E Sunshine St Ste Aa, Springfield, MO 65804-2114 | 2017-09-12 |
| 1740704667 | Mercy Management of Sepa | Family Medicine | 1001 Baltimore Pike Ste 109, Springfield, PA 19064-2852 | 2017-08-02 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1790215853 | Vincent Marchese | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2017-06-12 |
| 1184152100 | Canaan Arceneaux | Family Medicine | 1001 Baltimore Pike Ste 106, Springfield, PA 19064-2800 | 2017-06-03 |
| 1063943587 | Cody Stark Rogers | Family Medicine | 1423 N Jefferson Ave # A100, Springfield, MO 65802-1988 | 2017-03-26 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65802 |
Please comment or provide details below to improve the information on VICTORIA RENEE 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.