TERRY JACKSON (NPI# 1235569849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235569849 |
| Entity Type | Individual |
| Full Name | TERRY JACKSON |
| Practice Address |
6605 S 18th Dr Phoenix AZ 85041-5841 |
| Practice Telephone | 9897148157 |
| Mailing Telephone | 9897148157 |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2013-11-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
5167765 | AZ | Respite Care Facility |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056871 | Terry Lynn Jackson | Nurse Practitioner | 4922 General Ashley Dr, Bossier City, LA 71112-4764 | 2020-09-02 |
| 1649888223 | Terry Lamont Jackson | Specialist | 1101 E Yandell Dr, El Paso, TX 79902-5524 | 2020-07-20 |
| 1790281830 | Terry L. Jackson | Registered Nurse | 2052 S Dye Rd, Flint, MI 48532-4122 | 2018-04-05 |
| 1447590468 | Terry Elizabeth Jackson | Counselor | 6801 Us Highway 27 N, Suite A2, Sebring, FL 33870-7840 | 2013-02-28 |
| 1588736771 | Terry L Jackson | Dentist | 121 West Main Street, Watertown, TN 37184 | 2006-11-14 |
| 1811067606 | Terry Lewis Jackson | Counselor | 17 W Water St, Pinckneyville, IL 62274-1027 | 2006-11-08 |
| 1932106234 | Terry S Jackson | Internal Medicine | 560 W Mitchell St, Suite 300, Petoskey, MI 49770-2275 | 2005-06-30 |
| Street Address |
6605 S 18TH DR |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85041-5841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558915843 | Our Home of Unity LLC | Counselor | 6804 S 21st Dr, Phoenix, AZ 85041 | 2019-07-25 |
| 1447816590 | Mbong Jerry Ngwese | Physical Therapist | 2546 West Bloch Rd, Phoenix, AZ 85041 | 2019-05-14 |
| 1588228373 | Arizona Dental Management | Dentist | 3515 West Southern Avenue, Suite #152, Phoenix, AZ 85041 | 2019-04-26 |
| 1447780135 | Mesa Dental Arizona LLC | Dentist | 3320 W Southern Ave #111, Phoenix, AZ 85041 | 2017-06-14 |
| 1932564697 | Job Elliott | Counselor | 4105 W Saint Charles Ave, Phoenix, AZ 85041 | 2015-12-23 |
| 1376914739 | Black Family and Child Services Inc | Community/Behavioral Health | 6811 West 33rd Ave, Phoenix, AZ 85041 | 2015-10-12 |
| 1972900983 | Love Living Life | Assisted Living Facility | 5737 S. 34th Ave, Phoenix, AZ 85041 | 2014-11-20 |
| 1891114641 | Maricopa County Special Health Care District | General Acute Care Hospital | 5650 S 35th Ave, Phoenix, AZ 85041 | 2014-04-09 |
| 1265616213 | Southern Dental | Dentist | 3320 W. Southern Avenue, Suite # 108, Phoenix, AZ 85041 | 2007-12-27 |
| 1518140086 | Arizona Cvs Stores,l.l.c. | Durable Medical Equipment & Medical Supplies | 7550 South 19th Ave, Phoenix, AZ 85041 | 2007-12-07 |
| Find all providers in zip 85041 | ||||
| Taxonomy Code | 385HR2055X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Illness, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416595 | Tyechia Webb | Respite Care | 21239 N 24th Ave Apt 214, Phoenix, AZ 85027-2524 | 2019-09-12 |
| 1912552381 | Leslie E Alfieri | Respite Care | 2250 E Deer Valley Rd Unit 48, Phoenix, AZ 85024-5530 | 2019-08-02 |
| 1811404437 | Montique S Collins | Respite Care | 729 W Maldonado Rd, Phoenix, AZ 85041-6763 | 2018-01-04 |
| 1801341441 | Asha Dey | Respite Care | 1914 W Carson Rd, Phoenix, AZ 85041-6658 | 2016-08-24 |
| 1811352016 | Megan Pirehpour | Respite Care | 25622 N Singbush Loop, Phoenix, AZ 85083-2457 | 2015-12-15 |
| 1093109050 | Ligia Ahumada | Respite Care | 7111 W Pioneer St, Phoenix, AZ 85043-7209 | 2015-03-26 |
| 1871914119 | Debbie Okojie | Respite Care | 4041 N 27th St Unit 110, Phoenix, AZ 85016-6773 | 2014-01-03 |
| 1578993895 | Ronald Harris | Respite Care | 2512 W Saint Catherine Ave, Phoenix, AZ 85041-5354 | 2013-11-22 |
| 1245579895 | Annette Keil | Respite Care | 3901 E Emile Zola Ave, Phoenix, AZ 85032-6225 | 2013-02-01 |
| 1871847574 | Julia Ann Darby | Respite Care | 2821 S 63rd Dr, Phoenix, AZ 85043-7762 | 2012-11-01 |
| Find all providers in PHOENIX | ||||
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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.