KENNETH JASON JACKSON (NPI# 1174083810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174083810 |
| Entity Type | Individual |
| Full Name | KENNETH JASON JACKSON |
| Credential | MD |
| Practice Address |
320 23rd St S Apt 1418 Arlington VA 22202-3773 |
| Practice Telephone | 8433454674 |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639469026 | Kenneth T Jackson | Counselor | 25506 Virginia Dr, Warren, MI 48091-6002 | 2011-04-19 |
| 1396968863 | Kenneth J Jackson | Dentist | 809 Redskin Trail, Wapakoneta, OH 45895 | 2007-04-11 |
| 1972510352 | Kenneth Wayne Jackson | Nurse Practitioner | 1811 Memorial Dr, Clarksville, TN 37043-4604 | 2006-08-01 |
| 1487606943 | Kenneth Wade Jackson Jr. | Obstetrics & Gynecology | 22 Manningfield Dr, Fletcher, NC 28732-9457 | 2006-05-16 |
| 1275514994 | Kenneth Conrad Jackson II | Pharmacist | 546 Chipeta Way, Suite 220, Salt Lake City, UT 84108-1236 | 2005-11-09 |
| 1407409063 | Kenneth Jackson | Technician | 1005 Terminal Way Ste 125, Reno, NV 89502-2198 | 2019-07-22 |
| 1457857690 | Kenneth D Jackson | Counselor | 2775 State Route 39, Shelby, OH 44875-9466 | 2018-04-05 |
| 1528573714 | Kenneth Jackson | Case Manager/Care Coordinator | 1501 Madison Rd, Walnut Hills, OH 45206-1706 | 2017-12-10 |
| 1003328550 | Kenneth Lee Jackson Jr. | Counselor | 1430 S High St Fl 4, Columbus, OH 43207-1045 | 2017-10-24 |
| 1942674411 | Kenneth David Jackson Jr. | Case Manager/Care Coordinator | 3901 Ulloa St, New Orleans, LA 70119-6942 | 2015-11-21 |
| Street Address |
320 23RD ST S APT 1418 |
| City | ARLINGTON |
| State | VA |
| Zip Code | 22202-3773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881291474 | Gail Devonna Johnson | Home Health Aide | 2611 S Clark St Suite 700, Arlington, VA 22202 | 2020-10-06 |
| 1194331835 | Keylah Cherri Adams | Home Health Aide | 2611 South Clark Street Suite 700, Arlington, VA 22202 | 2020-09-18 |
| 1902412927 | Briggitte Marie Bradley | Home Health Aide | 2611 S Clark St. Suite 700, Arlington, VA 22202 | 2020-09-16 |
| 1730793027 | Regina Ray | Home Health Aide | 2611 South Clark Street, St.700, Arlington, VA 22202 | 2020-09-03 |
| 1255944328 | Elizabeth Ann Mayes Gross | Home Health Aide | 2611 S. Clark Street, 700, Arlington, VA 22202 | 2020-08-28 |
| 1942826425 | Maria Eugenia Flores | Home Health Aide | 2611 South Clark Street, Suite 700, Arlington, VA 22202 | 2020-06-22 |
| 1013531250 | Alistair Taylor | Student in an Organized Health Care Education/Training Program | Potomac Behavioral Solutions, 2001 Richmond Highway, Suite 800, Arlington, VA 22202 | 2020-06-03 |
| 1194349399 | Solange Abel Anagho | Home Health Aide | 2611 South Clark Street, Suite 700, Arlington, VA 22202 | 2020-06-03 |
| 1083256028 | Home Is Love Home Healthcare, LLC | Home Health | 575 12th Road S, Apt 231, Arlington, VA 22202 | 2019-10-10 |
| 1619521150 | Sarah Elizabeth Young | Physician Assistant | 1601 23rd St S, Arlington, VA 22202 | 2019-08-01 |
| Find all providers in zip 22202 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538768726 | Katherine Bailey Smith | Student in an Organized Health Care Education/Training Program | 3535 N Ohio St, Arlington, VA 22207-1337 | 2020-10-20 |
| 1316551906 | Tiny Tots | Student in an Organized Health Care Education/Training Program | 216 Kenosha Ln, Arlington, TX 76002-5433 | 2020-09-01 |
| 1528686011 | Samantha Mendoza | Student in an Organized Health Care Education/Training Program | 715 Valley Vista Rd Apt 2020, Arlington, TX 76006-2121 | 2020-07-10 |
| 1093331860 | Lucy Cao Nguyen | Student in an Organized Health Care Education/Training Program | 2308 Point Star Dr, Arlington, TX 76001-5806 | 2020-06-17 |
| 1013531250 | Alistair Taylor | Student in an Organized Health Care Education/Training Program | Potomac Behavioral Solutions, 2001 Richmond Highway, Suite 800, Arlington, VA 22202 | 2020-06-03 |
| 1043834633 | Hannah Bacon | Student in an Organized Health Care Education/Training Program | 850 N Randolph St Apt 313, Arlington, VA 22203-4004 | 2020-05-30 |
| 1902426083 | Britany Leeann Reierson | Student in an Organized Health Care Education/Training Program | 303 7th Ave Nw, Arlington, MN 55307-9544 | 2020-04-20 |
| 1235758327 | Bradley Cundiff | Student in an Organized Health Care Education/Training Program | 2000 N Adams St Apt 301, Arlington, VA 22201-3721 | 2020-04-09 |
| 1710513759 | Krishna Patel | Student in an Organized Health Care Education/Training Program | 4014 Shady Forge Trl, Arlington, TX 76005-4543 | 2020-03-22 |
| 1255962700 | Dunya Mounir Imad | Student in an Organized Health Care Education/Training Program | 1910 Columbia Pike, Arlington, VA 22204-4628 | 2020-02-03 |
| Find all providers in ARLINGTON | ||||
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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.