BRIAN JEFFREY JACKSON (NPI# 1134636921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134636921 |
| Entity Type | Individual |
| Full Name | BRIAN JEFFREY JACKSON |
| Credential | CO, AT |
| Practice Address |
1600 University Ave W Ste 10 Saint Paul MN 55104-3898 |
| Mailing Address |
1258 Galtier St Saint Paul MN 55117-4456 |
| Practice Telephone | 6516467246 |
| Practice Fax Number | 6516410726 |
| Mailing Telephone | 6512605993 |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Z00000X | Orthotist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083198659 | Brian John Jackson | Physician Assistant | 391 Lee Blvd Ste 300, Lehigh Acres, FL 33936-4973 | 2018-09-19 |
| 1316482425 | Brian Keith Jackson | Community Health Worker | 3714 Ruffin Rd, North Prince George, VA 23860-8629 | 2016-12-28 |
| 1346610011 | Brian Jackson | Counselor | 3008 Conmar St, Shreveport, LA 71108 | 2015-10-06 |
| 1255421855 | Brian R Jackson | Pathology | 500 E Chipeta Way, Salt Lake City, UT 84108-1221 | 2006-10-13 |
| 1467497461 | Brian D Jackson | Allergy & Immunology | 151 Harmony Park Circle, Hot Springs, AR 71913 | 2006-06-17 |
| 1689665408 | Brian E Jackson | Dentist | 2775 Bishop Rd, Suite C, Willoughby Hills, OH 44092-2683 | 2005-11-01 |
| 1306842356 | Brian D Jackson | Podiatrist | 1215 Hatcher Ln, Columbia, TN 38401-3531 | 2005-06-23 |
| 1477150738 | Brian Leslie Jackson | Registered Nurse | 2751 Napa Valley Corporate Dr Bldg B, Napa, CA 94558-6216 | 2020-10-08 |
| 1558973115 | Brian Lee Jackson | Pharmacist | 5780 Terry Rd, Byram, MS 39272-9745 | 2020-08-17 |
| 1174080030 | Brian Jeffry Jackson | Nurse Practitioner | 2075 San Joaquin Hills Rd, Newport Beach, CA 92660-6505 | 2019-02-27 |
| Street Address |
1600 UNIVERSITY AVE W STE 10 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55104-3898 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205886561 | Candyce Ann Powell | Physical Therapist | 1600 University Ave W Ste 10, Saint Paul, MN 55104-3898 | 2006-05-10 |
| 1487294401 | Impact Physical Medicine of St. Paul | Physical Medicine & Rehabilitation | 1600 University Ave W Ste 10, Saint Paul, MN 55104-3898 | 2020-01-07 |
| 1326580556 | Stephen Wilson | Massage Therapist | 1600 University Ave W Ste 10, Saint Paul, MN 55104-3898 | 2016-11-04 |
| 1124572862 | Cynthia Jane Mueller | Occupational Therapist | 1600 University Ave W Ste 10, Saint Paul, MN 55104-3898 | 2016-08-11 |
| 1689021586 | Impact Physical Medicine | Clinic/Center | 1600 University Ave W Ste 10, Saint Paul, MN 55104-3898 | 2016-05-20 |
| 1144417668 | Elizabeth Ann Mayotte | Occupational Therapist | 1600 University Ave W Ste 10, Impact Physical Medicine, Saint Paul, MN 55104-3898 | 2007-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339131 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 University Ave West, Suite 12, Room P, Saint Paul, MN 55104 | 2019-10-30 |
| 1629541644 | Michael P Cain | Counselor | 1821 University Ave West, Suite N385, St. Paul, MN 55104 | 2019-01-03 |
| 1295219657 | Awaken Recovery Center L.l.c | Counselor | 400 Suite D 393 North Dunlap, St Paul, MN 55104 | 2018-09-21 |
| 1285115634 | American Current Care of Minnesota PC | Clinic/Center | 570 Asbury St Ste 101, Saint Paul, MN 55104 | 2018-08-23 |
| 1699262501 | B & M Vital Homecare LLC. | Home Health | 1821 University Ave., W., Ste #s334, St. Paul, MN 55104 | 2018-04-16 |
| 1134621600 | Lauren Fullerton | Counselor | 1821 University Ave W., Suite N385, St. Paul, MN 55104 | 2018-03-01 |
| 1265944672 | Megan Manning | Marriage & Family Therapist | 475 Cleveland Ave. N., Suite 316, St. Paul, MN 55104 | 2017-10-26 |
| 1801305131 | Foncham Buma Foncham | Registered Nurse | 856 University Avenue, W, St. Paul, MN 55104 | 2017-09-29 |
| 1750802476 | Ha Vo | Counselor | 451 Lexington Parkway North, St. Paul, MN 55104 | 2017-07-03 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| Find all providers in zip 55104 | ||||
| Taxonomy Code | 222Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Orthotist |
| A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952576225 | Patrick Scott Hinshon | Orthotist | 1949 University Ave W, Saint Paul, MN 55104-3427 | 2008-04-28 |
| 1619354305 | Bobbi Jo Mugaas | Orthotist | 360 Sherman St, Suite 160, Saint Paul, MN 55102-2564 | 2015-05-01 |
| 1497962708 | Scott Lynn Langston | Orthotist | 2200 University Ave W, #114, Saint Paul, MN 55114-1839 | 2007-05-17 |
| 1922215417 | Julie Ann Lien O'connell | Orthotist | 2200 University Ave W, #114, Saint Paul, MN 55114-1839 | 2007-05-16 |
| 1992786941 | Orthotic Care Services, LLP | Orthotist | 360 Sherman St, Suite 299, Saint Paul, MN 55102-2564 | 2005-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447893664 | Ever-care Orthotics & Prosthetics LLC | Orthotist | 1686 Village Trl E Unit 2, Maplewood, MN 55109-5830 | 2019-10-21 |
| 1013568229 | Dennis Leo Anco | Orthotist | 1854 Evergreen Draw, Woodbury, MN 55125-2306 | 2019-09-28 |
| 1508320722 | Kevin Andrew Symms | Orthotist | 26150 Oak Leaf Trl, Excelsior, MN 55331-8479 | 2019-01-23 |
| 1104337617 | Louis Chester Winskowski IIi | Orthotist | 50 14th Ave E Suite 114, Sartell, MN 56377 | 2017-10-24 |
| 1194953935 | Orthotic Care Services, LLP | Orthotist | 2545 Chicago Ave Ste 507, Minneapolis, MN 55404-4545 | 2009-07-01 |
| 1700025301 | Charles Joseph Schultz | Orthotist | 1 Veterans Dr # 121, Va Medical Center, Minneapolis, MN 55417-2309 | 2009-02-05 |
| 1528596442 | Sean Orthotics LLC | Orthotist | 10 Central Ave, Osseo, MN 55369-1241 | 2017-05-24 |
| 1760923346 | Lisa Ann Harvey | Orthotist | 750 E 34th St, Suite 2260, Hibbing, MN 55746-2341 | 2017-03-15 |
| 1306177944 | Richard Anthony Weber | Orthotist | 2025 East River Pkwy, Shriners Hospitals for Children Twin Cities, Minneapolis, MN 55414-3604 | 2010-01-21 |
| 1215268859 | Wendy Joan Schifsky-gunelson | Orthotist | 2025 East River Parkway, Shriners Hospitals for Children Twin Cities, Minneapolis, MN 55414-3604 | 2010-01-21 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 55104 |
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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.