LEE SA B. JACKSON (NPI# 1306837042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306837042 |
| Entity Type | Individual |
| Full Name | LEE SA B. JACKSON |
| Other Name | LEE SA B. BACA |
| Credential | M.D. |
| Practice Address |
4824 E Baseline Rd Suite 110 Mesa AZ 85206-4676 |
| Mailing Address |
4824 E Baseline Rd Ste 110 Mesa AZ 85206-4678 |
| Practice Telephone | 4806152020 |
| Practice Fax Number | 4802199957 |
| Mailing Telephone | 4806152020 |
| Mailing Fax Number | 4802199957 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2016-12-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 25793 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 404731 | 05 |
| Street Address |
4824 E BASELINE RD SUITE 110 |
| City | MESA |
| State | AZ |
| Zip Code | 85206-4676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144220526 | Christopher R Carlson | Physician Assistant | 4824 E Baseline Rd, Suite 113, Mesa, AZ 85206-4676 | 2005-07-28 |
| 1548614936 | Cooper Duane Anderson | Chiropractor | 4824 E Baseline Rd, Mesa, AZ 85206-4676 | 2016-04-21 |
| 1871976456 | Dylan Thomas | Dentist | 4824 E Baseline Rd, #140, Mesa, AZ 85206-4676 | 2015-07-01 |
| 1467848242 | Dewane Arthur Brueske | Dentist | 4824 E Baseline Rd, Ste 140, Mesa, AZ 85206-4676 | 2015-04-08 |
| 1497144786 | Rachael Greensides | Nurse Practitioner | 4824 E Baseline Rd, 3-125, Mesa, AZ 85206-4676 | 2015-01-09 |
| 1902219256 | New Direction Fertility Centers | Obstetrics & Gynecology | 4824 E Baseline Rd, Suite 132, Mesa, AZ 85206-4676 | 2014-06-04 |
| 1861804429 | Chad Joseph Wolsey | Chiropractor | 4824 E Baseline Rd, Suite 140, Mesa, AZ 85206-4676 | 2014-05-29 |
| 1730422692 | Arizona Women's Health Partners Pllc | Obstetrics & Gynecology | 4824 E Baseline Rd, Ste 129, Mesa, AZ 85206-4676 | 2013-03-29 |
| 1134467970 | Verve Physical Therapy Group LLC | Physical Therapist | 4824 E Baseline Rd, Suite 140, Mesa, AZ 85206-4676 | 2013-01-30 |
| 1255676300 | Raheel Ashraf Mann | Chiropractor | 4824 E Baseline Rd, Ste 140, Mesa, AZ 85206-4676 | 2012-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891241964 | Arizona Retina Associates, Pllc | Ophthalmology | 6262 E Broadway Rd Ste 106, Mesa, AZ 85206-6101 | 2016-08-29 |
| 1982834834 | Jared David Peterson | Ophthalmology | 220 S 63rd Street, Swagel-wootton-hiatt Eye Center, Mesa, AZ 85206 | 2009-07-24 |
| 1902829799 | Matthew Hammond I | Ophthalmology | 1500 S Dobson Rd Ste 313, Mesa, AZ 85202-4752 | 2006-07-25 |
| 1477573913 | Arizona Pediatric Eye Specialists, Plc | Ophthalmology | 1520 S Dobson Rd Ste 202, Mesa, AZ 85202-4726 | 2006-07-20 |
| 1942232798 | Robert C Spurny Sr. | Ophthalmology | 6402 E Superstition Springs Blvd Ste 104, Mesa, AZ 85206-4391 | 2006-07-06 |
| 1063480119 | Craig R Cassidy | Ophthalmology | 160 W University, Suite 1, Mesa, AZ 85201 | 2006-03-14 |
| 1013985274 | Valley Eye Specialists P L C | Ophthalmology | 160 W University Dr, Ste 1, Mesa, AZ 85201-5833 | 2006-03-14 |
| 1851364814 | John M Lewis | Ophthalmology | 4760 E Falcon Dr Ste 101, Mesa, AZ 85215-2528 | 2006-02-09 |
| 1730169608 | Grant W Heinz | Ophthalmology | 6007 E Baseline Rd Ste 101, Mesa, AZ 85206-4801 | 2006-01-18 |
| 1104819804 | Michael A Pachtman | Ophthalmology | 1220 S Higley Rd Ste 106, Mesa, AZ 85206-4001 | 2005-08-26 |
| Find all providers in MESA | ||||
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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.