JOHN A JACKSON (NPI# 1063454122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063454122 |
Entity Type | Individual |
Full Name | JOHN A JACKSON |
Credential | M.D. |
Practice Address |
1055 N Curtis Rd Boise ID 83706-1309 |
Mailing Address |
Po Box 9649 Boise ID 83707-4649 |
Practice Telephone | 2083672161 |
Mailing Telephone | 2084728100 |
Mailing Fax Number | 2084728172 |
Enumeration Date | 2006-06-12 |
Last Update Date | 2011-10-13 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
M8926 | ID | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | 806864300 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801439799 | John Archie Jackson Jr. | Counselor | 209 Martin Luther King Dr, Elizabethtown, NC 28337 | 2019-10-23 |
1063073310 | John Jackson | Speech-Language Pathologist | 2143 Mohawk Trl, Maitland, FL 32751-3950 | 2019-06-27 |
1992202832 | John Jackson | Physical Therapy Assistant | 209 Lake St, Chittenango, NY 13037-1518 | 2018-04-08 |
1063911105 | John Martin Jackson | Physical Therapy Assistant | 11118 Lantern Way, North Chesterfield, VA 23236-3575 | 2018-02-05 |
1184164493 | John Jackson | Emergency Medical Technician, Paramedic | 137 S Newport Ave, Newport, WA 99156-1942 | 2017-03-06 |
1508236837 | John Willard Jackson | Anesthesiology | 7857 Caruth Ct, Dallas, TX 75225-8133 | 2015-09-29 |
1043572035 | John Ferndale Jackson | Behavioral Analyst | 931 Azure Heights Place, Las Vegas, NV 89110 | 2012-06-14 |
1679830558 | John Michael Jackson | Pharmacist | 1000 Castlebay, Cincinnati, OH 45245-4910 | 2012-04-18 |
1013043553 | John Phillip Jackson | Occupational Therapist | 7810 Avenue U Apt B, Lubbock, TX 79423-2430 | 2007-02-26 |
1275673451 | John W Jackson | Pharmacist | 1667 Bellemeade Dr, Altoona, PA 16602-7402 | 2007-02-07 |
Street Address |
1055 N CURTIS RD |
City | BOISE |
State | ID |
Zip Code | 83706-1309 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235122284 | Christopher Jay Sjoberg | Nurse Practitioner | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2005-08-24 |
1689287021 | Brian Jones | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-08-25 |
1346868759 | Rhianna Wallace | Occupational Therapist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-07-12 |
1447877824 | Chelsea Zipse | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-07-01 |
1770105181 | Eric Munoz Quiroz | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2020-05-08 |
1477197036 | Megan Lenkersdorfer | Hospitalist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-11-06 |
1104477967 | Paul David Cochran | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-24 |
1649820259 | Monica Marie Mclain | Pharmacist | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-16 |
1619526613 | Calan Szmyd | Genetic Counselor, MS | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-09-11 |
1922650613 | Allison A. Martinez | Nurse Anesthetist, Certified Registered | 1055 N Curtis Rd, Boise, ID 83706-1309 | 2019-07-12 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164993010 | Brette Marie Stephenson | Counselor | 1529 Belmont St., Boise, ID 83706 | 2018-12-17 |
1295249241 | Boise of Cascadia, LLC | Skilled Nursing Facility | 6000 W. Denton St., Boise, ID 83706 | 2017-11-29 |
1174035638 | Zacharia Njoroge | Physician Assistant | 1055 N Curtis Rd 6th Floor, Boise, ID 83706 | 2017-10-24 |
1740708965 | Total Renal Care Inc | Clinic/Center | 1070 N Curtis Rd Ste 125, Boise, ID 83706 | 2017-09-08 |
1023532173 | Amber Frisch | Massage Therapist | 2509 S Gekeler Lane, Boise, ID 83706 | 2017-07-31 |
1952768145 | Katie Garcin | Specialist | 1407 E Boston Dr, Boise, ID 83706 | 2016-01-20 |
1770950677 | Kathryn Bender | Counselor | 1205 N Garden St, Boise, ID 83706 | 2015-08-26 |
1457751802 | Sabrina Shumar | Physician Assistant | 901 N Curtis Rd Ste 501, Boise, ID 83706 | 2014-09-03 |
1831525070 | Katie Joy Wilson | Social Worker | 333 W. Rossi St. #300, Boise, ID 83706 | 2013-09-19 |
1609208610 | Christine Lea Eden | Surgery | 1075 N Curtis Rd Ste 101, Boise, ID 83706 | 2013-07-31 |
Find all providers in zip 83706 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376920553 | Creighton Lewis | Radiology | 500 West Fort St. #111r, Boise Vamc, Boise, ID 83702 | 2015-04-27 |
1295926061 | Michael Modica | Radiology | 877 W Main St, Suite 603, Boise, ID 83702-5883 | 2007-08-07 |
1346457298 | John Charles Kirkham | Radiology | 115 W Main St Ste 202, Boise, ID 83702-7303 | 2007-05-17 |
1811046386 | Frank J Daniels | Radiology | 5122 S Surprise Way Apt 202, Boise, ID 83716-9050 | 2007-01-10 |
1821039025 | Michael J Ryan | Radiology | 232 S Whisperwood Way, Boise, ID 83709-4900 | 2006-06-09 |
1679513303 | Intermountain Medical Imaging LLC | Radiology | 161 E Mallard Dr, Suite 120, Boise, ID 83706-5015 | 2006-06-08 |
1669423679 | Intermountain Medical Imaging LLC | Radiology | 927 W Myrtle St, Boise, ID 83702-7061 | 2006-05-15 |
1174589543 | Laura M Wike | Radiology | 2517 N Cisco Ln, Boise, ID 83702-5502 | 2006-04-25 |
1922077635 | Ryan Slaughter | Radiology | 907 Harrison Blvd, Boise, ID 83702-4052 | 2006-03-15 |
1336554740 | Geoffry De Gennaro Jr. | Radiology | 190 E Bannock St, Boise, ID 83712-6241 | 2014-06-24 |
Find all providers in BOISE |
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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.