MR. THOMAS WILLIAM JACKSON MSPT (NPI# 1326682618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326682618 |
| Entity Type | Individual |
| Full Name | MR. THOMAS WILLIAM JACKSON MSPT |
| Credential | PT |
| Practice Address |
1200 Driving Park Ave Newark NY 14513-1090 |
| Mailing Address |
Po Box 111 Newark NY 14513-0111 |
| Practice Telephone | 3153322289 |
| Mailing Telephone | 3153322289 |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
011505-1 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1200 DRIVING PARK AVE |
| City | NEWARK |
| State | NY |
| Zip Code | 14513-1090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396741898 | Lawrence N. Chessin | Internal Medicine | 1200 Driving Park Ave, Newark, NY 14513-1057 | 2005-06-21 |
| 1477162725 | Aidan Sullivan | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2020-07-23 |
| 1649898834 | Nicholas D Biermann | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2020-07-14 |
| 1780222604 | Erin Hart | Physical Therapist | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-12-11 |
| 1861030785 | Lauren Conaty | Physical Therapist | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-12-11 |
| 1255978540 | Andrea Lorene Ide | Physical Therapist | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-12-05 |
| 1578113189 | Natalie A Davidson | Nurse Practitioner | 1200 Driving Park Ave, Newark, NY 14513 | 2019-09-16 |
| 1164076659 | Meritt F Rogers | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-08-01 |
| 1992366744 | Allison Marie Triou | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-06-24 |
| 1467918250 | Poonam Parmar | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-02-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881215648 | Susan Marie Oberdorf | Speech-Language Pathologist | 133 Elmwood, Newark, NY 14513 | 2020-05-04 |
| 1871077404 | Aisha E Wagner | Nurse Practitioner | 1304 Driving Park Avenue, Newark, NY 14513 | 2018-09-19 |
| 1689192817 | Melanie Swarthout | Case Manager/Care Coordinator | 150 Van Buren St., Newark, NY 14513 | 2017-09-08 |
| 1942650882 | Donna Joy Collins I | Speech-Language Pathologist | 848 Pierson Avenue, Newark, NY 14513 | 2016-06-21 |
| 1972952661 | Cj-mak Transportation, Inc. | Non-emergency Medical Transport (VAN) | 227 State Farm Road, Newark, NY 14513 | 2016-06-03 |
| 1306214473 | Stephanie Belli | Licensed Practical Nurse | 5904 Austin Road, Newark, NY 14513 | 2015-09-08 |
| 1992186712 | Nicole Harris | Nursing Facility/Intermediate Care Facility | 132 Willow Avenue, Newark, NY 14513 | 2015-06-17 |
| 1861802373 | Jeffrey Spencer | Urology | 1202 Driving Park Ave Ste 5, Newark, NY 14513 | 2014-05-06 |
| 1609126648 | Natasha Triplett | Student in an Organized Health Care Education/Training Program | 439 W. Maple Ave, Perkins Elementary, Newark, NY 14513 | 2012-09-18 |
| 1922377902 | Lisa E. Williams | Licensed Practical Nurse | 701 Peirson Ave., Newark, NY 14513 | 2011-12-21 |
| Find all providers in zip 14513 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215982418 | William Holland | Physical Therapist | 2717 Pulaski Hwy, Newark, DE 19702-3960 | 2006-05-24 |
| 1467937631 | Elanna Kitsios Arhos | Physical Therapist | 540 S College Ave, Newark, DE 19713-1302 | 2018-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760152 | Molly Ripp | Physical Therapist | 1165 Northern Blvd Ste 403, Manhasset, NY 11030-3048 | 2020-11-02 |
| 1982202024 | Integrated Pt2 Pllc | Physical Therapist | 4720 Center Blvd Apt 3006, Long Island City, NY 11109-5648 | 2020-10-12 |
| 1891392940 | Dr Omolola Omishore Pt, P.C. | Physical Therapist | 1138 Ocean Ave Apt 6i, Brooklyn, NY 11230 | 2020-10-01 |
| 1912514704 | Hochung Jeon | Physical Therapist | 4545 Center Blvd Apt 904, Long Island City, NY 11109-5917 | 2020-09-25 |
| 1831704469 | Colleen M Brough | Physical Therapist | 710 W 168th St Ste 336, New York, NY 10032-3726 | 2020-09-10 |
| 1225641731 | Kyle Dillon | Physical Therapist | 667 Stoneleigh Ave Ste 11, Carmel, NY 10512-2454 | 2020-08-25 |
| 1346853033 | R.l. Physical Therapy | Physical Therapist | 1676 Putney Road, Valley Stream, NY 11580 | 2020-08-24 |
| 1194335059 | Donn Samson | Physical Therapist | 8762 52nd Ave Fl 2, Elmhurst, NY 11373-3938 | 2020-08-05 |
| 1679195499 | Vital Rehab LLC | Physical Therapist | 3165 Nostrand Ave Apt 4e, Brooklyn, NY 11229-3243 | 2020-05-14 |
| 1508485657 | Melvin Varghese | Physical Therapist | 172 Hoover Rd, Yonkers, NY 10710-3409 | 2020-04-09 |
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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.