RICHARD J JACKSON (NPI# 1215027883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215027883 |
| Entity Type | Individual |
| Full Name | RICHARD J JACKSON |
| Credential | MD |
| Practice Address |
1901 Sw H K Dodgen Loop Temple TX 76502-3500 |
| Mailing Address |
Po Box 844658 Dallas TX 75284-4658 |
| Practice Telephone | 2549354000 |
| Practice Fax Number | 2549354111 |
| Mailing Telephone | 2547242111 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
N-8271 | AR | Allopathic & Osteopathic Physicians |
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
N3094 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 121627001 | 05 | |
| TX | 125912907 | 05 | |
| TX | 137345810 | 05 | |
| TX | 140442852 | 05 | |
| TX | 125912908 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629520770 | Richard Allen Jackson | Social Worker | 201 W Laurel St, Brainerd, MN 56401-3902 | 2016-10-25 |
| 1386924363 | Richard Ray Jackson | Social Worker | 104 S Ridge Ave, Troy, OH 45373-2704 | 2011-08-23 |
| 1124240197 | Richard Jackson | Psychologist | 2650 West 2700 South, Syracuse, UT 84075 | 2007-05-02 |
| 1508081993 | Richard Jackson | Psychiatry & Neurology | E 4111 Andover Road Suite 220, Bloomfield Hills, MI 48302 | 2007-04-13 |
| 1851478101 | Richard Jackson | Pharmacist | 420 Delaware St Se # Mmc812, Minneapolis, MN 55455-0341 | 2006-11-01 |
| 1972616134 | Richard Pharus Jackson | Optometrist | 216 W Washington St, Anthony, TX 79821-9304 | 2006-08-15 |
| 1801810163 | Richard Edwin Jackson | Dentist | 109 Timbermill Dr, Lexington, SC 29073-7138 | 2006-07-27 |
| 1366483406 | Richard D Jackson | Family Medicine | 29 Eastbrook Rd, Ronks, PA 17572-9769 | 2006-06-09 |
| 1659328060 | Richard Jackson | Emergency Medicine | 505 Regency Xing, Southlake, TX 76092-9501 | 2006-05-30 |
| 1174587505 | Richard E Jackson | Physician Assistant | 21260 Olean Blvd Ste 200, Port Charlotte, FL 33952-6742 | 2006-04-13 |
| Street Address |
1901 SW H K DODGEN LOOP |
| City | TEMPLE |
| State | TX |
| Zip Code | 76502-3500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982681177 | Robin Ann Weerts | Nurse Anesthetist, Certified Registered | 1901 Sw H K Dodgen Loop, Temple, TX 76502 | 2005-12-28 |
| 1205458296 | Connor Travis Larson | Nurse Anesthetist, Certified Registered | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2020-05-12 |
| 1285277061 | Charity Ann Driver | Nurse Practitioner | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-10-23 |
| 1780232223 | Ahmed Gamal Aquino | Counselor | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-08-28 |
| 1629620778 | Cristiane Rocha Krohn | Registered Nurse | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-07-09 |
| 1801356159 | Daniel Dvoskin | Student in an Organized Health Care Education/Training Program | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-03-22 |
| 1720546039 | Irma Valle | Nurse Anesthetist, Certified Registered | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-03-05 |
| 1316411200 | Jadon Kirven | Counselor | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2019-01-14 |
| 1801371414 | Chad Krumpholz | Physician Assistant | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2018-09-28 |
| 1629550983 | Hailey Marek | Occupational Therapist | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2018-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710850 | Bih Mobanoe Chi | Pharmacist | 6801 West Adams Avenue, Temple, TX 76502 | 2020-11-06 |
| 1639705403 | Robert David Pompella | Chiropractor | 4805 Stone Ridge Dr, Temple, TX 76502 | 2020-03-12 |
| 1275167488 | Luong Dental, LLC | Dentist | 5297 S. 31st Street, Ste 111, Temple, TX 76502 | 2020-02-26 |
| 1093357931 | Ryan T Stephens Dmd Pllc | Dentist | 5408 W. Adams Suite 102, Temple, TX 76502 | 2019-10-11 |
| 1164071817 | Danyelle Denise Pividori | Licensed Vocational Nurse | 992 Marlandwood Rd, Temple, TX 76502 | 2019-09-05 |
| 1831670652 | Jane Lida Jarosz | Registered Nurse | 99 Marlandwood, Temple, TX 76502 | 2018-08-29 |
| 1043791809 | Elsa Gamban Baker | Licensed Practical Nurse | 5711 Hopkins Dr, Temple, TX 76502 | 2018-08-28 |
| 1659859288 | Laura Bright | Licensed Vocational Nurse | 990 Marlanwood, Temple, TX 76502 | 2018-08-06 |
| 1811489974 | Rockdale Blackhawk, LLC | Clinic/Center | 1909 Sw Hk Dodgen Loop, Temple, TX 76502 | 2018-06-05 |
| 1871094573 | Moc Temple, LLC | Skilled Nursing Facility | 725 Marlandwood Rd., Temple, TX 76502 | 2018-02-27 |
| Find all providers in zip 76502 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063685956 | Kelly Dawn Mattix | Surgery | 2401 S 31st St, Temple, TX 76508-0001 | 2008-04-11 |
| 1235261181 | Danny Carlton Little | Surgery | 2401 S 31st St, Temple, TX 76508-0001 | 2007-03-09 |
| 1417973926 | Robert Todd Maxson | Surgery | 1901 Sw H K Dodgen Loop, Temple, TX 76502 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255775169 | Natasha Corbitt | Surgery | 1935 Medical District Dr Ste D2000, Dallas, TX 75235-7701 | 2013-04-22 |
| 1821327362 | South Texas Health Alliance | Surgery | 528 North Union Street, Suite 250, New Braunfels, TX 78130 | 2009-12-11 |
| 1356519565 | Children's Physician Services of South Texas | Surgery | 3533 S Alameda St Ste 302, Corpus Christi, TX 78411-1721 | 2008-02-11 |
| 1821271503 | Charles E. Baldwin Md | Surgery | 18866 Stone Oak Pkwy # 103-21, San Antonio, TX 78258-4180 | 2007-12-17 |
| 1801845318 | Ambrosio Hernandez IIi | Surgery | 1120 E Ridge Rd, Mcallen, TX 78503-5411 | 2006-05-10 |
| 1477516201 | Jane Franklin Goldthorn | Surgery | 4102 22nd Pl, Lubbock, TX 79410-1122 | 2006-04-11 |
| 1528049723 | Charles Thomas Black | Surgery | 12200 Park Central Dr Ste 400, Dallas, TX 75251-2116 | 2005-11-07 |
| 1578554895 | William W Spurbeck | Surgery | 5340 El Paso Dr Ste M, El Paso, TX 79905-2837 | 2005-11-04 |
| 1104820554 | Charles Eugene Baldwin | Surgery | 502 Madison Oak Drive, Suite 330, San Antonio, TX 78258-4298 | 2005-06-13 |
| 1649870304 | Parkhill Surgery Center Plano, LLC | Surgery | 7000 W Plano Pkwy, Plano, TX 75093-8466 | 2020-10-30 |
| Find all providers with the same taxonomy | ||||
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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.