WESLEY MATTHEW JACKSON (NPI# 1225396690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225396690 |
| Entity Type | Individual |
| Full Name | WESLEY MATTHEW JACKSON |
| Credential | M.D. |
| Practice Address |
5801 Mountain Island Dr Durham NC 27713-8909 |
| Practice Telephone | 8174282404 |
| Mailing Telephone | 8174282404 |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2018-01-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
207903 | NC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295266120 | Wesley Jackson | Occupational Therapy Assistant | 2102 Sandbrook Dr, Jonesboro, AR 72404-0686 | 2017-03-22 |
| 1285085357 | Wesley Alexander Jackson | Podiatrist | 534 W John St Ste 100, Matthews, NC 28105-5484 | 2016-06-29 |
| 1073511127 | Wesley Gordon Jackson | Surgery | 2441 Sample Ave, Clovis, CA 93611-5495 | 2005-07-12 |
| 1336775972 | Wesley Eric Jackson | Behavior Technician | 1226 Independence Ave, Kennett, MO 63857-1316 | 2020-03-16 |
| 1194782995 | Wesley P Jackson | Orthopaedic Surgery | 2500 E Prospect Rd, Fort Collins, CO 80525-9718 | 2006-04-27 |
| Street Address |
5801 MOUNTAIN ISLAND DR |
| City | DURHAM |
| State | NC |
| Zip Code | 27713-8909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558977074 | Zoe Wellness | Clinic/Center | 5322 Nc 55, 102, Durham, NC 27713 | 2020-09-21 |
| 1194352542 | Mariah Davis | Counselor | 1822 East Hwy Nc 54, Suite 300, Durham, NC 27713 | 2020-03-25 |
| 1316589138 | Monarch | Community/Behavioral Health | 1513 Piperwood Court, Durham, NC 27713 | 2019-10-14 |
| 1205486081 | Lisa Mesmer Barnes | Nurse Practitioner | 5309hwy 55, Suite 105, Durham, NC 27713 | 2019-09-13 |
| 1497315352 | Mary Therese Wood | Social Worker | 1822 E Highway 54, Suite 300, Durham, NC 27713 | 2019-06-13 |
| 1720558307 | Kevin D Simmons | Counselor | 1822 Nc Hwy 54 Suite 300, Durham, NC 27713 | 2018-11-27 |
| 1790265585 | Kelli Cryer | Counselor | 54 E Nc Hwy 1822, Suite 300, Durham, NC 27713 | 2018-08-21 |
| 1477039253 | Mahavir Rx, LLC | Pharmacy | 6216 Fayetteville Rd Ste 105, Durham, NC 27713 | 2018-07-16 |
| 1811482862 | Tessa Taylor | Dentist | 2515 E Nc Highway 54 Ste 2000, Durham, NC 27713 | 2018-06-22 |
| 1013401579 | Emily Louise Haller | Counselor | 1822 E Hwy 54, Suite 300, Durham, NC 27713 | 2018-06-19 |
| Find all providers in zip 27713 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306023742 | Scott Allan Witt | Pediatrics | Duke University Medical Center Department of Pediatrics, Dumc Box 3179, Durham, NC 27710-0001 | 2008-01-29 |
| 1952689481 | John Ryan Heinrick | Pediatrics | 2301 Erwin Rd, Duke University Hospital, Durham, NC 27705-4699 | 2011-08-02 |
| 1144475369 | Waleed M Maamoun El Dawy | Pediatrics | 2100 Erwin Rd, Durham, NC 27705-3941 | 2008-12-02 |
| 1619179843 | Robert William Lenfestey | Pediatrics | 2100 Erwin Rd, Durham, NC 27710-0001 | 2007-06-01 |
| 1790986776 | Phillip Brian Smith | Pediatrics | Duke University Medical Ctr, Box 3179, Durham, NC 27710-0001 | 2007-05-29 |
| 1073730958 | Eric J. Benner | Pediatrics | 2100 Erwin Rd, Durham, NC 27705-3941 | 2007-04-20 |
| 1588727358 | Charles Michael Cotten | Pediatrics | 2100 Erwin Rd, Durham, NC 27710-0001 | 2006-12-19 |
| 1356404123 | Susan Izatt | Pediatrics | 2100 Erwin Rd, Durham, NC 27710-0001 | 2006-12-19 |
| 1457414237 | David Tanaka | Pediatrics | 2100 Erwin Rd, Durham, NC 27710-0001 | 2006-12-19 |
| 1467515239 | Ronald Goldberg | Pediatrics | 2100 Erwin Rd, Durham, NC 27710-0001 | 2006-12-19 |
| Find all providers in DURHAM | ||||
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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.