DR. THOMAS E JACKSON (NPI# 1245330950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245330950 |
| Entity Type | Individual |
| Full Name | DR. THOMAS E JACKSON |
| Credential | MD |
| Practice Address |
47 Maple St #205 Summit NJ 07901 |
| Practice Telephone | 9085229400 |
| Practice Fax Number | 9085223226 |
| Mailing Telephone | 9085229400 |
| Mailing Fax Number | 9085223226 |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2010-06-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MA48570 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 11383 | 01 | |
| OXFORD | UP138 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811463334 | Thomas Spencer Jackson | Dentist | 1507 E Lamar Alexander Pkwy, Maryville, TN 37804-5131 | 2018-10-23 |
| 1255698759 | Thomas Jackson | Social Worker | 5240 Creed Dr, Summerfield, NC 27358-8284 | 2012-04-20 |
| 1851628549 | Thomas W Jackson | Dentist | 8160 Perry Hwy, Pittsburgh, PA 15237-5214 | 2009-11-17 |
| 1134380694 | Thomas Michael Jackson | Emergency Medicine | 7 Bitterroot Road, Carmen, ID 83462 | 2008-06-18 |
| 1528181666 | Thomas Burton Jackson | Psychiatry & Neurology | 41750 Rancho Las Palmas Dr Ste D2, Rancho Mirage, CA 92270-5512 | 2007-04-06 |
| 1992827398 | Thomas Jackson | Social Worker | 228 Maple St, Middlebury, VT 05753-1606 | 2007-04-04 |
| 1528117306 | Thomas Boyd Jackson | Social Worker | 5225 Baysdon Cir, Jackson Consultant Services, LLC, Indianapolis, IN 46235-6040 | 2007-01-09 |
| 1679590137 | Thomas W Jackson | Psychiatry & Neurology | 3010 Beard Rd., Napa, CA 94558 | 2006-07-17 |
| 1306818968 | Thomas Cozatt Jackson Jr. | Family Medicine | 470 Linden Ave, Harrodsburg, KY 40330-1871 | 2006-02-07 |
| 1154308997 | Thomas L Jackson | Specialist | 2450 N Park Dr, Columbus, IN 47203-2216 | 2005-12-22 |
| Street Address |
47 MAPLE ST #205 |
| City | SUMMIT |
| State | NJ |
| Zip Code | 07901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790242212 | Elizabeth Russo Putnam | Occupational Therapist | 88 Mountain Ave, Summit, NJ 07901 | 2019-02-21 |
| 1821536152 | Nyree Tchalikian | Social Worker | 467 Springfield Avenue, Suites 201-202, Summit, NJ 07901 | 2017-02-07 |
| 1891149050 | Trucare Homehealth Services, Inc | Health Maintenance Organization | 86 Summit Ave Suite Ll200, Summit, NJ 07901 | 2016-04-14 |
| 1043672975 | Brendan P. Mccollum, Md LLC | Clinic/Center | 33 Overlook Rd., Suite 210, Summit, NJ 07901 | 2016-03-21 |
| 1972917086 | Family and Sports Medicine Institute of New Jersey LLC | Physical Medicine & Rehabilitation | 33 Upper Overlook Rd, Suite 305, Summit, NJ 07901 | 2014-06-17 |
| 1639589666 | Adonis Cheng | Physician Assistant | Overlook Medical Center, 99 Beauvoir Avenue, Summit, NJ 07901 | 2014-04-29 |
| 1932542693 | Brian Patrick Thornton Jr. | Counselor | 33 Upper Overlook Road, Suite 210, Summit, NJ 07901 | 2013-04-12 |
| 1285977371 | Rehab Universe, LLC | Clinic/Center | 137 Springfield Ave, 2nd Floor, Summit, NJ 07901 | 2013-03-27 |
| 1568702348 | Summit Board of Education | Local Education Agency (LEA) | 14 Beekman Terrace, Summit, NJ 07901 | 2013-02-15 |
| 1538418082 | Dana N Cohen | Psychologist | 86 Summit Avenue, Summit Psychological Services, Summit, NJ 07901 | 2012-08-30 |
| Find all providers in zip 07901 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548609381 | Michael Mobasser | Internal Medicine | 10 Overlook Rd, Summit, NJ 07901-3554 | 2013-06-14 |
| 1275845729 | Chantal Mulan Lisik | Internal Medicine | 252 Kent Place Blvd, Summit, NJ 07901 | 2010-07-12 |
| 1770771016 | Lorraine Maita | Internal Medicine | 64 River Rd Fl 1, Summit, NJ 07901-1443 | 2007-10-11 |
| 1275743510 | Victoria Elana Rand | Internal Medicine | 149 Oak Ridge Ave, Summit, NJ 07901 | 2007-05-23 |
| 1003964420 | Manoj M Trivedi | Internal Medicine | 802 Old Springfield Ave, Summit, NJ 07901-1130 | 2007-01-08 |
| 1295813996 | Nazeer Shaik | Internal Medicine | 7604 W 63rd St, Summit, IL 60501-1812 | 2006-11-01 |
| 1679671721 | Hospitalist Associates Inc | Internal Medicine | 99 Beauvoir Ave 8th Fl, Summit, NJ 07901 | 2006-09-20 |
| 1598878910 | Kalyani Theivanayagam | Internal Medicine | 276 Woodland Ave, Summit, NJ 07901-1437 | 2006-08-17 |
| 1528035938 | Arathi Setty | Internal Medicine | 33 Overlook Rd Ste L01, Summit, NJ 07901-3561 | 2006-03-03 |
| 1811985203 | Jon E Hershkowitz | Internal Medicine | 120 Summit Ave, Summit Medical Group, Summit, NJ 07901-2804 | 2005-10-10 |
| Find all providers in SUMMIT | ||||
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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.