DR. KASEY B. JACKMAN (NPI# 1356651194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356651194 |
| Entity Type | Individual |
| Full Name | DR. KASEY B. JACKMAN |
| Credential | PHD, RN, PMHNP-BC |
| Practice Address |
130 Powerville Rd Boonton NJ 07005-8705 |
| Mailing Address |
66 Mountain Ave Mendham NJ 07945-1321 |
| Practice Telephone | 9733161800 |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2018-11-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
26NJ00314300 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
F401331-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
130 POWERVILLE RD |
| City | BOONTON |
| State | NJ |
| Zip Code | 07005-8705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982661971 | Suman Lata Jalan | Psychiatry & Neurology | 130 Powerville Rd, Boonton, NJ 07005-8705 | 2006-04-26 |
| 1740800481 | Kristin Far | Social Worker | 130 Powerville Rd, Boonton, NJ 07005-8705 | 2020-04-23 |
| 1154940518 | Allyson Daly | Social Worker | 130 Powerville Rd, Boonton, NJ 07005-8705 | 2020-04-15 |
| 1144856261 | Gabrielle Fresse | Social Worker | 130 Powerville Rd, Boonton, NJ 07005-8705 | 2020-03-20 |
| 1760017867 | Sarah Cho | Social Worker | 130 Powerville Rd, Boonton, NJ 07005-8705 | 2020-03-09 |
| 1295366508 | Jessica Ellen Troxler | Social Worker | 130 Powerville Rd, Boonton, NJ 07005-8705 | 2020-01-27 |
| 1528698115 | Hannah Gooen | Social Worker | 130 Powerville Rd, Boonton, NJ 07005-8705 | 2020-01-22 |
| 1801431143 | Serina Pino | Marriage & Family Therapist | 130 Powerville Rd, Boonton, NJ 07005-8705 | 2019-11-11 |
| 1134763303 | Shelley English | Social Worker | 130 Powerville Rd, Boonton, NJ 07005-8705 | 2019-10-31 |
| 1093366395 | Cassandra A Merklinghaus | Social Worker | 130 Powerville Rd, Boonton, NJ 07005-8705 | 2019-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669997524 | Kyle Feather | Physical Therapist | 315 Wootton Street, Units G and H, Boonton, NJ 07005 | 2017-08-11 |
| 1629445234 | Eric Capell | Preventive Medicine | 102 Boonton Ave, Boonton, NJ 07005 | 2015-08-31 |
| 1639553530 | The Rose House | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 929 Knoll Rd., Parsippany-troy Hills, NJ 07005 | 2015-07-10 |
| 1912241340 | Generation Pharmacy Group, LLC. | Pharmacy | 85 Fulton Street, Suite 9a, Boonton, NJ 07005 | 2012-11-26 |
| 1639323512 | Anna Marie Williams | Social Worker | 408 Main St Ste 204, Boonton, NJ 07005 | 2008-11-05 |
| 1275796286 | Yurata Gerwel Modzelewski | Pediatrics | 105 Powerville Road, Boonton Twp, NJ 07005 | 2008-07-09 |
| 1467656280 | Suzanne L. Feuer | Counselor | Saint Clares Health System, 130 Powerville Road, Boonton, NJ 07005 | 2007-06-14 |
| 1619029261 | Laura Jean Nowak | Social Worker | 130 Powerville Road, Boonton, NJ 07005 | 2007-01-16 |
| 1891842803 | Wilda Mesias | Psychologist | 550 West Main St, Boonton, NJ 07005 | 2007-01-04 |
| 1710912332 | Philip Mark Scaduto | Internal Medicine | 223 West Main St, Boonton, NJ 07005 | 2006-07-12 |
| Find all providers in zip 07005 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699297168 | Echo Blue Enterprise LLC | Nurse Practitioner | 550 W Main St, Boonton, NJ 07005-1168 | 2017-07-16 |
| 1548643430 | Brianna Scancarella | Nurse Practitioner | 130 Powerville Rd, Boonton, NJ 07005 | 2015-07-09 |
| 1407108582 | Alexter Mutia | Nurse Practitioner | 130 Powerville Rd, Boonton, NJ 07005-8705 | 2012-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699943 | Ernest Akwaboah | Nurse Practitioner | 87 Burnett Ave, Maplewood, NJ 07040-3094 | 2020-11-04 |
| 1548861081 | Temitope Akande | Nurse Practitioner | 557 Liberty St, Orange, NJ 07050-1275 | 2020-11-02 |
| 1538767587 | Ruth Yamoah-cofie | Nurse Practitioner | 1160 E 7th St, Plainfield, NJ 07062-1906 | 2020-10-13 |
| 1336756170 | Jacqueline Michele Arnone | Nurse Practitioner | 105 Windward Dr, Manahawkin, NJ 08050-3345 | 2020-09-25 |
| 1750997789 | Eunice Ramos | Nurse Practitioner | 300-a Forest Avenue, Paramus, NJ 07652 | 2020-09-15 |
| 1174138952 | Darlene Lupo | Nurse Practitioner | 72 Morris Ave, Neptune, NJ 07753 | 2020-09-09 |
| 1841804960 | Claudette L Blake | Nurse Practitioner | 890 Terrill Rd, Plainfield, NJ 07062-2250 | 2020-09-04 |
| 1982217873 | Ifeoma E Iherobiem | Nurse Practitioner | 884 S Springfield Ave Apt 18, Springfield, NJ 07081-3320 | 2020-08-28 |
| 1871106088 | Firmin Langyin | Nurse Practitioner | 200 Station Dr Apt 207, Avenel, NJ 07001-1793 | 2020-08-26 |
| 1205448859 | Yanick E Jean | Nurse Practitioner | 32 Deerfield Dr, West Orange, NJ 07052-3627 | 2020-08-17 |
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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.