THERESA JACKSON (NPI# 1164818993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164818993 |
| Entity Type | Individual |
| Full Name | THERESA JACKSON |
| Credential | M.D. |
| Practice Address |
4629 E 13th Pl Tulsa OK 74112-6103 |
| Practice Telephone | 4058228297 |
| Mailing Telephone | 4058228297 |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2020-01-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 32423 | OK | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | BP10052439 | TX | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 1164818993 | OK | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144767906 | Theresa A Jackson | Community Health Worker | 3112 33rd St Ne, Canton, OH 44705-3869 | 2017-01-31 |
| 1104207083 | Theresa Jackson | Chore Provider | 77 E Great Lakes St Apt 303, River Rouge, MI 48218-1584 | 2015-06-16 |
| 1063832509 | Theresa Jackson | Counselor | 18 J Braden Thompson Rd, Forestdale, MA 02644-1555 | 2014-04-23 |
| 1083947592 | Theresa Michelle Jackson | Registered Nurse | 337 E 197th St, Euclid, OH 44119-1121 | 2009-09-15 |
| 1841486289 | Theresa Y Jackson | Massage Therapist | 1803 Boulevard, Jacksonville, FL 32206-4342 | 2007-09-19 |
| 1790332443 | Theresa Lynn Jackson | Dietitian, Registered | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2019-08-19 |
| 1093280422 | Theresa Jackson | Massage Therapist | 3647 Cedar Ave S, Minneapolis, MN 55407-2919 | 2018-10-12 |
| 1275021834 | Theresa E. Jackson | Social Worker | 2392 Edgewood Ave N, Jacksonville, FL 32254-1725 | 2018-04-28 |
| 1568709335 | Theresa F Jackson | Pharmacist | 3550 Centerville Hwy, Snellville, GA 30039-4133 | 2013-01-13 |
| 1154506681 | Theresa Jackson | Social Worker | 2100 Comer Ave, Columbus, GA 31904-8725 | 2008-01-03 |
| Street Address |
4629 E 13TH PL |
| City | TULSA |
| State | OK |
| Zip Code | 74112-6103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457824161 | Dawn Medi Spa, Inc | Nurse Practitioner | 1243 South Harvard Ave, Dawn Medi Spa, Inc, Tulsa, OK 74112 | 2019-01-04 |
| 1598121063 | All American Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 8740 E 11th St, Suite B, Tulsa, OK 74112 | 2016-01-13 |
| 1619341229 | Mauricia Stokes | Social Worker | 2325 S. Harvard Ave, Tulsa, OKLAHOMA 74112 | 2015-11-19 |
| 1053711762 | Montanta Cummings | Case Manager/Care Coordinator | 1901 S 68th E Ave, Apt 112b, Tulsa, OK 74112 | 2014-08-29 |
| 1134439862 | Janet Augerhole | Speech-Language Pathologist | 1724 S. Harvard Ave, Tulsa, OK 74112 | 2010-10-15 |
| 1457517872 | Palmer Continuum of Care | Community/Behavioral Health | 711 S. Sheridan Rd., Tulsa, OK 74112 | 2008-08-05 |
| 1386767820 | Tanya Jolene Skotarek Tuffour | Counselor | 501 S. Pittsburg Ave, Tulsa, OK 74112 | 2007-04-09 |
| 1376655860 | Gerald D Chicoine | Chiropractor | 3739 E 11th St, Tulsa, OK 74112 | 2006-08-31 |
| 1780791590 | Mark A Smalley | Social Worker | 3712 E 11th Street, Tulsa, OK 74112 | 2006-08-25 |
| 1841717311 | Kenneth I Fields IIi | Pharmacist | 6336 E 4th Pl, Tulsa, OK 74112 | 2017-08-25 |
| Find all providers in zip 74112 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457715799 | John Carl Sacra | Emergency Medicine | 7911 S. Hudson Pl, Tulsa, OK 74136 | 2016-04-13 |
| 1730568965 | Brianne C Roepke | Emergency Medicine | 744 West 9th St, Tulsa, OK 74127-9028 | 2015-05-20 |
| 1710371448 | Medexpress Urgent Care, PC - Oklahoma | Emergency Medicine | 2140 S Yale Avenue, Tulsa, OK 74114-2122 | 2015-03-19 |
| 1992148407 | Kevin Thomas Kierl | Emergency Medicine | 1145 S Utica Ave Fl 6, Tulsa, OK 74104-4000 | 2013-04-15 |
| 1467715300 | Mednow Urgent Care Center LLC | Emergency Medicine | 7127 S Olympia, Tulsa, OK 74132 | 2012-06-15 |
| 1437457009 | Matthew Jenkins | Emergency Medicine | 20 E 5th St Ste 620, Tulsa, OK 74103-4441 | 2011-03-07 |
| 1073819314 | Shane Marshall | Emergency Medicine | 4813 S 187th East Ave, Tulsa, OK 74134-7203 | 2011-02-03 |
| 1316178874 | Wyatt-dean Avery Pickering | Emergency Medicine | 1223 S Lawton Ave, Tulsa, OK 74127-9173 | 2009-08-01 |
| 1891959581 | Michael Richard Schiesel | Emergency Medicine | 1923 S Knoxville Ave, Tulsa, OK 74112-6841 | 2008-07-11 |
| 1235257593 | William Henry Dudney | Emergency Medicine | 6080 S. Sheridan, Tulsa, OK 74145-9212 | 2007-03-26 |
| Find all providers in TULSA | ||||
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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.