DR. KARL W. JACKSON (NPI# 1124011218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124011218 |
| Entity Type | Individual |
| Full Name | DR. KARL W. JACKSON |
| Credential | PH.D. |
| Practice Address |
311 Nilles Rd Suite D Fairfield OH 45014-2636 |
| Practice Telephone | 5138586810 |
| Practice Fax Number | 5138601131 |
| Mailing Telephone | 5138586810 |
| Mailing Fax Number | 5138601131 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2009-01-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
2040681A | IN | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
5930 | OH | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215483433 | Karl Jackson | Counselor | 1619 Sunnyacres Rd, Copley, OH 44321-2330 | 2016-08-28 |
| 1326481383 | Karl Dwight Jackson | Massage Therapist | 39 Nw Louisiana Ave, Bend, OR 97701-3310 | 2013-04-09 |
| Street Address |
311 NILLES RD SUITE D |
| City | FAIRFIELD |
| State | OH |
| Zip Code | 45014-2636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003917154 | Moorthy Medical Associates, LLC | Neurological Surgery | 311 Nilles Rd, Ste G, Fairfield, OH 45014-2636 | 2006-09-25 |
| 1376564849 | Palanivel G Moorthy | Psychiatry & Neurology | 311 Nilles Rd, Ste G, Fairfield, OH 45014-2636 | 2006-07-21 |
| 1003864752 | Rahib N Vasi | Internal Medicine | 311 Nilles Rd, Ste C, Fairfield, OH 45014-2621 | 2006-05-05 |
| 1770531436 | Dummi P Yathiraj | Internal Medicine | 311 Nilles Rd, Ste C, Fairfield, OH 45014-2621 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326526872 | Megan Coleen Hamill | Registered Nurse | 6570 Sosna Drive, Fairfield, OH 45014 | 2018-08-06 |
| 1831695642 | James Grant Walther | Contractor | 16408 Jeanie Drive, Aurora, IN 45014 | 2018-04-02 |
| 1104339837 | Tamara Rochester | Registered Nurse | 5474 Yellowstone Dr, Fairfield, OH 45014 | 2017-11-16 |
| 1104335892 | Barbara Johnson | Registered Nurse | 2853 Saturn Drive, Fairfield, OH 45014 | 2017-09-25 |
| 1205373537 | Samuel E Ghee IIi | Counselor | Decoach Rehabilitation Center, 6570 Sosna Drive, Fairfield, OH 45014 | 2017-01-25 |
| 1669916789 | Lacretia Ancona | In Home Supportive Care | 700 Wessel Dr #181505, Fairfield, OH 45014 | 2016-12-08 |
| 1134676299 | Lynne Mutuku | Licensed Practical Nurse | 3975 Woodridge Blvd, Apt 10, Fairfield, OH 45014 | 2016-09-07 |
| 1104291020 | Mimi Supportive Hands .llc | Home Health | 6 Ridge Dr Apt 203, Cincinnati, OH 45014 | 2015-12-03 |
| 1215319181 | Brittany Beck | Social Worker | 3050 Mack Rd Ste 205, Fairfield, OH 45014 | 2015-06-26 |
| 1093193278 | Ashli Tanner | Specialist/Technologist | 8790 N. Gilmore Rd., Fairfield, OH 45014 | 2015-05-08 |
| Find all providers in zip 45014 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407404684 | Siobhan O'leary Evarts | Psychologist | 1275 Post Rd Ste A18, Fairfield, CT 06824-6060 | 2019-08-30 |
| 1164887949 | Kara Emery | Psychologist | 520 Chadbourne Rd, Fairfield, CA 94534-9453 | 2015-12-22 |
| 1619220563 | April Justine Young | Psychologist | 712 Texas St, Fairfield, CA 94533-5519 | 2012-10-16 |
| 1306147350 | Dody J. Reustle | Psychologist | 711 Jefferson Street, Suite 202, Fairfield, CA 94533-5556 | 2010-11-08 |
| 1033438015 | Dr. Katherine Bothos, LLC | Psychologist | 170 Post Rd Ste 208, Fairfield, CT 06824-6242 | 2010-05-29 |
| 1740506054 | Agila Rangarajan | Psychologist | 2812 Mack Rd, Fairfield, OH 45014-5130 | 2010-04-12 |
| 1114254836 | Katherine Bothos | Psychologist | 170 Post Rd, Suite 208, Fairfield, CT 06824-6242 | 2009-11-17 |
| 1871764076 | Norma Jean Van Volkinburg | Psychologist | 694 A Street, Travis Air Force Base To, Fairfield, CA 94535 | 2008-03-14 |
| 1033388327 | Erin R Frick | Psychologist | 728 Texas St, Suite 3, Fairfield, CA 94533-5560 | 2008-02-21 |
| 1679768329 | Pioli Psychological Services | Psychologist | 1495 Black Rock Turnpike, Fairfield, CT 06825 | 2007-09-06 |
| Find all providers in FAIRFIELD | ||||
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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.