DENISE JACKSON (NPI# 1306330303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306330303 |
| Entity Type | Individual |
| Full Name | DENISE JACKSON |
| Practice Address |
11720 Medlock Bridge Rd Ste 155 Johns Creek GA 30097 |
| Mailing Address |
11720 Medlock Bridge Rd Ste 155 Johns Creek GA 30097-1513 |
| Practice Telephone | 5743203549 |
| Mailing Telephone | 5743203549 |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2018-06-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 224P00000X | Prosthetist | BC29700281 | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 224P00000X | Prosthetist | CO124581 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134736275 | Denise Jackson | Massage Therapist | 102 Arborwood Dr, Anderson, SC 29621-5865 | 2020-09-23 |
| 1720403256 | Denise Ann Jackson | Social Worker | 1003 N Griffin Ave, Okmulgee, OK 74447-2512 | 2014-02-20 |
| 1982984118 | Denise Jackson | Case Manager/Care Coordinator | 1704 Highway 69, Trumann, AR 72472 | 2011-08-19 |
| 1871545772 | Denise L Jackson | Family Medicine | 10043 W Lincoln Hwy, Frankfort, IL 60423-1272 | 2006-05-17 |
| 1295732071 | Denise Serotta Jackson | Physical Therapist | Stephen W. Bassin, P.t., P.C., 32 Sherman Ave, Glen Falls, NY 12801 | 2005-07-07 |
| 1669030649 | Denise Jackson | Counselor | 200 Casentini St, Salinas, CA 93907-2299 | 2019-06-04 |
| 1669930616 | Denise Jackson | Technician | 3110 Esther Pl Se, Washington, DC 20032-1505 | 2019-03-08 |
| 1538675632 | Denise Diane Jackson | Counselor | 1545 W 25th St, Cleveland, OH 44113-3158 | 2017-12-27 |
| 1093089906 | Denise Jackson | Physical Therapy Assistant | 10300 Southwest Hwy, Chicago Ridge, IL 60415-1426 | 2012-02-24 |
| 1124263710 | Denise Ann Jackson | Specialist | 204 E Main St, Palmyra, NY 14522-1128 | 2008-12-10 |
| Street Address |
11720 MEDLOCK BRIDGE RD STE 155 |
| City | JOHNS CREEK |
| State | GA |
| Zip Code | 30097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659986057 | Herman Medical Solutions, LLC | Internal Medicine | 10700 Medlock Bridge Road, Suite 207, Duluth, GA 30097 | 2020-09-11 |
| 1649808619 | Kirsty Amber Ramirez | Behavior Technician | 218 Premiere Pkwy #500, Duluth, GA 30097 | 2020-03-27 |
| 1386277820 | Cristina Madalina Niculas | Pharmacist | Kroger Pharmacy 476, 6555 Sugarloaf Parkway, Duluth, GA 30097 | 2020-02-12 |
| 1619514924 | Opesdei Health Solutions | Home Health Aide | 6615 Abbotts Bridge Road, 6615 Abbotts Bridge Road Unit 1111, Johns Creek, GA 30097 | 2019-12-05 |
| 1700422979 | Ria Alexander | Nurse Practitioner | 6300 Hospital Parkway Ste 300, Johns Creek, GA 30097 | 2019-11-22 |
| 1043867765 | Mosesal Zakia White | Nurse Practitioner | 10680 Medlock Bridge Rd #102, Johns Creek, GA 30097 | 2019-08-19 |
| 1982187068 | Lighthouse Clinical Counseling, LLC | Counselor | 3883 Rogers Bridge Road, Suite 601, Duluth, GA 30097 | 2018-09-13 |
| 1376025643 | Faithe Beanne Kimsey | Counselor | 3883 Rogers Bridge Road Nw, Suite 601, Duluth, GA 30097 | 2018-09-04 |
| 1407363328 | Berkeley Van Dyke | Physical Therapist | 6335 Hospital Pkwy Ste 316, Johns Creek, GA 30097 | 2017-12-30 |
| 1679005011 | Chadon Health Services Inc. | Health Maintenance Organization | 2180 Satelite Blvd, Ste 400, Duluth, GA 30097 | 2017-04-03 |
| Find all providers in zip 30097 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477152239 | Zachary T Hughes | Prosthetist | 1050 Barber Creek Dr Ste 103, Watkinsville, GA 30677-4502 | 2020-10-22 |
| 1306460662 | Unique Creationz Rx | Prosthetist | 2500 Dallas Hwy Sw Ste 202-1082, Marietta, GA 30064-2567 | 2020-06-02 |
| 1205450954 | Monique D Gay | Prosthetist | 2651 Favor Rd Sw # 1g06, Marietta, GA 30060-5241 | 2020-05-28 |
| 1134743891 | Jazmyn Monet Griffith | Prosthetist | 1564 Herrington Rd Apt 6112, Lawrenceville, GA 30043-7956 | 2020-05-28 |
| 1326661208 | Jasmine Dixon | Prosthetist | 390 Auburn Ave Ne, Atlanta, GA 30312-1544 | 2020-05-26 |
| 1659900702 | Shirleysia Jones | Prosthetist | 213 Paces Commons Dr, Duluth, GA 30096-1712 | 2020-04-01 |
| 1912545393 | Kanishia Gordon | Prosthetist | 519 Memorial Dr Se Ste 209, Atlanta, GA 30312-2286 | 2019-12-16 |
| 1922642826 | Juanita F Mike | Prosthetist | 6409 Guinness Ct, Union City, GA 30291-1991 | 2019-11-04 |
| 1003463787 | Denise Ann Hill | Prosthetist | 4308 Caveat Ct, Fairburn, GA 30213-4328 | 2019-08-19 |
| 1588224091 | Natalie Bennett | Prosthetist | 2864 Carrousel Ct, Stone Mountain, GA 30087-3922 | 2019-06-17 |
| Find all providers with the same taxonomy | ||||
| City | JOHNS CREEK |
| Zip Code | 30097 |
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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.