DR. KRISTEN B JACKSON (NPI# 1164760500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164760500 |
| Entity Type | Individual |
| Full Name | DR. KRISTEN B JACKSON |
| Credential | PH.D. |
| Practice Address |
480 Medical Center Dr Dodd Hall 2145 Columbus OH 43210-1229 |
| Practice Telephone | 6142933830 |
| Practice Fax Number | 6142934870 |
| Mailing Telephone | 6142933830 |
| Mailing Fax Number | 6142934870 |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2013-01-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TR0400X |
Psychologist Specialization: Rehabilitation |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316465347 | Kristen Jackson | Registered Nurse | 834 N Seminary St Ste 201, Galesburg, IL 61401-2898 | 2017-08-30 |
| 1255727061 | Kristen Jackson | Registered Nurse | 4028 Connors Way, Blasdell, NY 14219-2985 | 2015-04-08 |
| 1982008918 | Kristen Jackson | Nurse Practitioner | 3333 Bunet Avenue, Mlc 5021, Cincinnati, OH 45229-3026 | 2014-10-20 |
| 1801167267 | Kristen Jackson | Specialist | 1007 Sienna Dr, Danbury, CT 06810-7151 | 2012-01-17 |
| 1174804678 | Kristen M Jackson | Speech-Language Pathologist | 114 Lockett Ln, Saint George, KS 66535-9618 | 2011-08-29 |
| 1982211355 | Kristen Imani Jackson | Case Manager/Care Coordinator | 1995 Gentilly Blvd Ste C-400, New Orleans, LA 70119-1700 | 2020-09-29 |
| 1841839339 | Kristen Jackson | Physician Assistant | 6001 Stonewood Dr, Wexford, PA 15090-7380 | 2019-12-31 |
| 1952877045 | Kristen Lorraine Jackson | Physical Therapy Assistant | 720 Yorklyn Rd Ste 150, Hockessin, DE 19707-8729 | 2018-10-16 |
| 1518445634 | Kristen Jackson | Case Manager/Care Coordinator | 2404 Ferrand St Ste 24, Monroe, LA 71201-3233 | 2018-07-31 |
| 1861910499 | Kristen Staples Jackson | Speech-Language Pathologist | 701 Grove Rd, Greenville, SC 29605 | 2017-09-04 |
| Street Address |
480 MEDICAL CENTER DR DODD HALL 2145 |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43210-1229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033116827 | William S Pease | Physical Medicine & Rehabilitation | 480 Medical Center Dr, Room 1018, Columbus, OH 43210-1245 | 2005-07-07 |
| 1396344560 | Daniel Hurlburt | Psychologist | 480 Medical Center Dr, Columbus, OH 43210-1229 | 2020-10-20 |
| 1750905188 | Alex Eubank | Physical Therapist | 480 Medical Center Dr, Columbus, OH 43210-1229 | 2020-06-01 |
| 1578022125 | Francesco Sammartino | Neurological Surgery | 480 Medical Center Dr, Columbus, OH 43210-1229 | 2019-03-13 |
| 1518499649 | Nina Couette | Student in an Organized Health Care Education/Training Program | 480 Medical Center Dr, Columbus, OH 43210-1229 | 2017-03-29 |
| 1538517370 | Jennifer Elaine Gadawski | Nurse Practitioner | 480 Medical Center Dr, Columbus, OH 43210-1229 | 2016-06-02 |
| 1750737847 | Adam Loechler | Rehabilitation Hospital | 480 Medical Center Dr, Columbus, OH 43210-1229 | 2016-05-09 |
| 1043664899 | Ryan Mathew | Internal Medicine | 480 Medical Center Dr, Columbus, OH 43210 | 2016-04-19 |
| 1902265077 | Aristide Merola | Psychiatry & Neurology | 480 Medical Center Dr, Columbus, OH 43210-1229 | 2016-02-18 |
| 1518385020 | Bryan Coniglio | Internal Medicine | 480 Medical Center Dr, Columbus, OH 43210-1229 | 2014-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861014672 | Nadine El Ayouty | Dentist | 2082 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210 | 2020-05-14 |
| 1982233953 | Zacharia A Grami | Emergency Medicine | 774 Prior Hall, 376 West 10th Avenue, Columbus, OH 43210 | 2020-04-02 |
| 1578191219 | Kaitlyn Greiner | Student in an Organized Health Care Education/Training Program | The Ohio State University Wexner Center, 395 W 12th Avenue, Third Floor, Columbus, OH 43210 | 2020-03-30 |
| 1265069280 | Meryl P Sudhakar | Student in an Organized Health Care Education/Training Program | 774 Prior Hall 376 W 10th Ave, Columbus, OH 43210 | 2020-03-27 |
| 1124653514 | William A Jansak | Nurse Practitioner | The Richard M. Ross Heart Hospital, 4th Floor, 452 West 10th Ave, Columbus, OH 43210 | 2020-03-06 |
| 1114570058 | Suzanne Bartle Haring | Marriage & Family Therapist | 110 Bevis Hall, 1080 Carmack Rd, Columbus, OH 43210 | 2019-07-19 |
| 1487207387 | Mehak Kaul | Dentist | 2196 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210 | 2019-07-19 |
| 1043873920 | Andrew Kendle | Student in an Organized Health Care Education/Training Program | 774 Prior Hall, 374 W. 10th Ave, Columbus, OH 43210 | 2019-04-17 |
| 1093277840 | Cory Pettit | Student in an Organized Health Care Education/Training Program | The Ohio State Universty Wexner Medical Center, 395 W 12th Ave, 3rd Floor, Columbus, OH 43210 | 2019-04-02 |
| 1447711866 | Drew Michael S Donnell | Student in an Organized Health Care Education/Training Program | Osuwmc Dept of Surgery, 395 W. 12th Avenue, Room 662, Columbus, OH 43210 | 2019-03-28 |
| Find all providers in zip 43210 | ||||
| Taxonomy Code | 103TR0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750554473 | Bruce Steven Growick | Psychologist | 934 Middlebury Dr., Columbus, OH 43085-3466 | 2008-04-03 |
| 1952826943 | Eric Dean Anderson | Psychologist | 20 S 3rd St Ste 210, Columbus, OH 43215-4206 | 2017-08-10 |
| 1467721605 | Lynne Gauthier | Psychologist | 480 Medical Center Dr, 2145 Dodd Hall, Columbus, OH 43210-1229 | 2011-12-16 |
| 1104133289 | Janice Wunderle Bosley Phd LLC | Psychologist | 4775 Knightsbridge Blvd, Suite 203, Columbus, OH 43214-4313 | 2010-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710549134 | Daniel Harvey Mazalic | Psychologist | 8599 Knox School Rd, Minerva, OH 44657-9437 | 2019-07-05 |
| 1043631724 | Amy Ricciardi | Psychologist | 38820 Hidden Canyon Dr, Grafton, OH 44044-9222 | 2013-12-23 |
| 1679502553 | Rehabilitation Psychology, Inc. | Psychologist | 200 Bradenton Ave, Dublin, OH 43017-7515 | 2006-07-02 |
| 1003213844 | Frank Kenner | Psychologist | 2500 Metrohealth Dr, Cleveland, OH 44109-1900 | 2014-11-21 |
| 1558646406 | Sara Elizabeth Walters-bugbee | Psychologist | 10701 East Blvd, Psychology Service 116b, Cleveland, OH 44106-1702 | 2011-10-11 |
| 1245550250 | Behavioral Consultants LLC | Psychologist | 11206 Woodtown Rd, Galena, OH 43021-9638 | 2010-06-02 |
| 1205921061 | Bruce L Ladle | Psychologist | 30 E Apple St, Suite 6255, Dayton, OH 45409-2939 | 2006-10-04 |
| 1205847449 | Kip Smith | Psychologist | 2500 Metrohealth Dr, Mhmc-pm&r, Cleveland, OH 44109-1900 | 2006-08-11 |
| 1922032929 | Elizabeth K Dreben | Psychologist | 2500 Metrohealth Dr, Mhmc-pm&r, Cleveland, OH 44109-1900 | 2006-07-10 |
| 1053342840 | Anita B Gantner | Psychologist | 2500 Metrohealth Dr, Mhmc-pm&r, Cleveland, OH 44109-1900 | 2006-07-06 |
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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.