COLETTE JACKSON (NPI# 1174943138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174943138 |
| Entity Type | Individual |
| Full Name | COLETTE JACKSON |
| Credential | MD |
| Practice Address |
1000 19th St S Birmingham AL 35205-4804 |
| Mailing Address |
Po Box 751461 Charlotte NC 28275-1461 |
| Practice Telephone | 2059300700 |
| Practice Fax Number | 2059309127 |
| Mailing Telephone | 8437926200 |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2019-05-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 52176 | SC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
| Y | 207WX0110X |
Ophthalmology Specialization: Pediatric Ophthalmology and Strabismus Specialist |
37977 | AL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 171 Ashley Ave, Charleston, SC 29425 | 8437921414 | |
| 1000 19th St S, Birmingham, AL 352054804 | 2059300700 | 2059309127 |
| Street Address |
1000 19TH ST S |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35205-4804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031743 | Frederick John Elsas | Ophthalmology | 1000 19th St S, Birmingham, AL 35205-4804 | 2005-05-30 |
| 1033601414 | Allison Cheek Mckelvey | Optometrist | 1000 19th St S, Birmingham, AL 35205-4804 | 2018-06-01 |
| 1023471455 | Erik Richard Johnson | Ophthalmology | 1000 19th St S, Birmingham, AL 35205-4804 | 2016-04-02 |
| 1114362688 | Walter Tyson Parker | Ophthalmology | 1000 19th St S, Birmingham, AL 35205 | 2013-05-09 |
| 1528379716 | Jennifer Dudney Davidson | Ophthalmology | 1000 19th St S, Birmingham, AL 35205-4804 | 2010-06-23 |
| 1386847374 | Kristin Carroll Bains | Ophthalmology | 1000 19th St S, Birmingham, AL 35205-4804 | 2007-06-07 |
| 1366484941 | Alabama Ophthalmology Associates, P.C. | Eyewear Supplier (Equipment, not the service) | 1000 19th St S, Birmingham, AL 35205-4804 | 2006-06-11 |
| 1134122658 | Robert Lewis Phillips | Ophthalmology | 1000 19th St S, Birmingham, AL 35205-4804 | 2005-05-30 |
| 1861495384 | John Alva Long | Ophthalmology | 1000 19th St S, Birmingham, AL 35205-4804 | 2005-05-30 |
| 1740283266 | Matthew Gerard Vicinanzo | Ophthalmology | 1000 19th St S, Birmingham, AL 35205-4804 | 2005-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124547674 | Serve Home Health Care Agency, LLC | In Home Supportive Care | 2230 Green Springs Hwy S, Birmingham, AL 35205 | 2017-09-15 |
| 1457870487 | Marilyn Bennett Pinson | Pharmacist | Walgreens Store #15144, 3020 Clairmont Ave S, Birmingham, AL 35205 | 2017-09-11 |
| 1639522238 | Dana Rives | Speech-Language Pathologist | St. Vincent's, Building 3, Suite 402, Birmingham, AL 35205 | 2016-07-19 |
| 1760854236 | Raymond Herring | Chiropractor | 1226 29th St S, Apt 18, Birmingham, AL 35205 | 2015-10-23 |
| 1083005813 | Absolutely Amazing Salon | Prosthetic/Orthotic Supplier | 2227 Arlington Avenue, Birmingham, AL 35205 | 2015-02-16 |
| 1396141651 | Alexandria Hutchison | Occupational Therapist | 833 Saint Vincent's Drive, Building 3, Suite 200, Birmingham, AL 35205 | 2014-11-14 |
| 1790028199 | Patrick Ross Owens | Otolaryngology | 833 Saint Vincents Dr Ste 402, Birmingham, AL 35205 | 2013-04-03 |
| 1053657452 | David Mitchell Comfort | Urology | 2716 Hanover Circle, Unit 801, Birmingham, AL 35205 | 2012-12-13 |
| 1598023632 | Kathryn Ashley Bentley | Orthopaedic Surgery | 833 St. Vincent's Drive, Bldg 3, Ste 403, Birmingham, AL 35205 | 2012-04-26 |
| 1114298510 | Natalie Elizabeth George | Physician Assistant | 2100 16th Avenue South, 202, Birmingham, AL 35205 | 2012-01-18 |
| Find all providers in zip 35205 | ||||
| Taxonomy Code | 207WX0110X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Pediatric Ophthalmology and Strabismus Specialist |
| An ophthalmologist who specializes in pediatric ophthalmology and strabismus management. The subspecialty includes the medical and surgical management of eye disorders found in children. Some of the more common disorders include amblyopia, strabismus, refractive error, cataract and glaucoma. These disorders may be related to neurological and endocrinological diseases, trauma, or aging changes in the extraocular muscles requiring medical, optical and surgical management. |
| Notes: Source: American Academy of Ophthalmology, www.aao.org [7/1/2017: new] - Additional Resources: Association of University Professors of Ophthalmology, www.aupo.org. |
| City | BIRMINGHAM |
| Zip Code | 35205 |
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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.