ROBERT JACKSON (NPI# 1073942371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073942371 |
| Entity Type | Individual |
| Full Name | ROBERT JACKSON |
| Credential | L.M.T., M.M.P. |
| Practice Address |
502 11th St Se Decatur AL 35601-4908 |
| Practice Telephone | 2563519566 |
| Mailing Telephone | 2563519566 |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2013-11-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 852 | AL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701487 | Robert Jackson | Physical Therapist | 3056 Healthy Way Ste 116, Birmingham, AL 35243-2435 | 2019-10-11 |
| 1881003655 | Robert Donald Jackson | Social Worker | 151 Knollcroft Rd # 116d, Lyons, NJ 07939-5001 | 2014-08-06 |
| 1780005496 | Robert Earl Jackson Jr. | Community Health Worker | 17 Wickham Dr, Columbus, GA 31907-6328 | 2013-12-23 |
| 1447548573 | Robert Joseph Jackson | Licensed Practical Nurse | 5454 East State St, Hermitage, PA 16148 | 2011-07-11 |
| 1457515330 | Robert Anthony Jackson | Dentist | 2816 Veach Rd., Unit 305, Owensboro, KY 42303 | 2008-07-10 |
| 1437357399 | Robert D Jackson | Counselor | 5525 Erindale Dr Ste 112, Colorado Springs, CO 80918-6960 | 2007-07-03 |
| 1174736029 | Robert Allan Jackson | Physician Assistant | 2109 Brookview Ter Apt B, Pekin, IL 61554-7320 | 2007-05-08 |
| 1144389347 | Robert W Jackson | Dentist | 209 Mimosa Dr, Thomasville, GA 31792-6633 | 2006-12-06 |
| 1144305152 | Robert Eric Jackson | Internal Medicine | 291 Indian Lake Blvd, Hendersonville, TN 37075-3653 | 2006-10-26 |
| 1396834990 | Robert Jackson | Nurse Practitioner | 853 Longwood Ave, Bronx, NY 10459-4000 | 2006-10-12 |
| Street Address |
502 11TH ST SE |
| City | DECATUR |
| State | AL |
| Zip Code | 35601-4908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463029 | Danielle Wright | Massage Therapist | 132 S Water St Ste 430, Decatur, IL 62523-2305 | 2020-09-28 |
| 1093329435 | Donelle Julene Mcgaw | Massage Therapist | 2641 E College Ave Apt 504, Decatur, GA 30030-3316 | 2020-09-02 |
| 1134743438 | Kimberly A Knaus | Massage Therapist | 2934 S Mount Zion Rd, Decatur, IL 62521-9723 | 2020-06-02 |
| 1437770377 | Pierre Sanon | Massage Therapist | 1549 Clairmont Rd Ste 202, Decatur, GA 30033-4635 | 2020-05-01 |
| 1760941975 | Dasha A Price | Massage Therapist | 2836 Lavista Rd Ste D, Decatur, GA 30033-1301 | 2019-03-18 |
| 1912402975 | Clyde Ranney | Massage Therapist | 619 E College Ave Ste 627-h, Decatur, GA 30030-5324 | 2018-03-29 |
| 1134574916 | Melissa Hart | Massage Therapist | 2119 Westmead Dr Sw Ste 8, Decatur, AL 35603-1088 | 2016-04-28 |
| 1588024558 | Taika Howard | Massage Therapist | 1724 Derrill Dr, Decatur, GA 30032-4629 | 2016-03-03 |
| 1376916999 | Henry Grady Tucker IIi | Massage Therapist | 11 Sycamore Sq, Decatur, GA 30030-1952 | 2015-11-04 |
| 1578956496 | Katharine Taylor | Massage Therapist | 303 2nd Ave Se Ste 1, Decatur, AL 35601-2325 | 2015-03-17 |
| Find all providers in DECATUR | ||||
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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.