SAMUEL ELI JACKSON (NPI# 1376151266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376151266 |
| Entity Type | Individual |
| Full Name | SAMUEL ELI JACKSON |
| Practice Address |
1110 13th St Ste D Columbus GA 31901-2246 |
| Practice Telephone | 7067801704 |
| Mailing Telephone | 7067801704 |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811511199 | Samuel Collins Jackson | Physical Therapist | 1125 Landau Ln, Mt Pleasant, SC 29466-7300 | 2020-06-03 |
| 1689105223 | Samuel Barrett Jackson | Internal Medicine | 200 Ucla Medical Plz Ste 400, Los Angeles, CA 90095-7417 | 2017-03-24 |
| 1851556203 | Samuel S Jackson IIi | Dentist | 296 White Bridge Pike, Nashville, TN 37209-3226 | 2008-07-25 |
| 1588204721 | Samuel Richardson Jackson | Physical Therapist | 10438 Iron Bridge Rd, Chester, VA 23831-1427 | 2020-01-15 |
| 1114480001 | Samuel W Jackson | Student in an Organized Health Care Education/Training Program | 450 Clarkson Ave, Brooklyn, NY 11203-2012 | 2019-04-09 |
| 1699274993 | Samuel Robert Jackson | Physician Assistant | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2018-02-02 |
| 1255794160 | Samuel Jackson | Student in an Organized Health Care Education/Training Program | 4301 W Markham St, Slot 589, Little Rock, AR 72205-7101 | 2016-03-30 |
| Street Address |
1110 13TH ST STE D |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31901-2246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497204887 | Marissa Yoshikawa-machado | Counselor | 1110 13th St Ste D, Columbus, GA 31901-2246 | 2016-09-26 |
| 1629679618 | Jamar Gardner | Behavior Technician | 1110 13th St Ste D, Columbus, GA 31901-2246 | 2020-11-05 |
| 1427657170 | Hope Coffey Tidd | Behavior Technician | 1110 13th St Ste D, Columbus, GA 31901-2246 | 2020-10-23 |
| 1255930517 | Stephanie Paige Calhoun | Behavioral Analyst | 1110 13th St Ste D, Columbus, GA 31901-2246 | 2020-10-19 |
| 1952909764 | Jasmine Nelson | Behavior Technician | 1110 13th St Ste D, Columbus, GA 31901-2246 | 2020-10-14 |
| 1396343679 | Ebony A Sager | Behavior Technician | 1110 13th St Ste D, Columbus, GA 31901-2246 | 2020-10-09 |
| 1861099152 | Jessica Holloway | Behavior Technician | 1110 13th St Ste D, Columbus, GA 31901-2246 | 2020-10-08 |
| 1194339028 | Tazaya Thompson | Behavior Technician | 1110 13th St Ste D, Columbus, GA 31901-2246 | 2020-09-08 |
| 1093329906 | Stephanie Brazziel | Behavior Technician | 1110 13th St Ste D, Columbus, GA 31901-2246 | 2020-09-08 |
| 1639783566 | Valerie Lenderman | Behavior Technician | 1110 13th St Ste D, Columbus, GA 31901-2246 | 2020-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790396984 | Chisholm Trail Urgent Care Pllc | Emergency Medicine | 11 Tsys Way, Columbus, GA 31901 | 2020-08-12 |
| 1770040099 | Columbus Ga Homecare, LLC | In Home Supportive Care | 1501 13th Street., Suite G, Columbus, GA 31901 | 2019-02-22 |
| 1750868782 | Health Matters, Inc. | Clinic/Center | 1124 13th St, Columbus, GA 31901 | 2018-07-23 |
| 1447754197 | Charles Chacha Maroa Babere | Student in an Organized Health Care Education/Training Program | Columbus Regional Health, Midtown Medical Center, 1900 10th Avenue, Suit 100, Columbus, GA 31901 | 2018-03-19 |
| 1861912867 | Demetria Laprel Mcgruder | Community Health Worker | 1230 2nd Ave., Columbus, GA 31901 | 2017-06-21 |
| 1679932016 | Crystal Gayle Passmore | Counselor | 233 12th St Ste 334, Columbus, GA 31901 | 2016-02-13 |
| 1700256344 | Kendra Ward | Community Health Worker | 1230 2nd Avenue, Columbus, GA 31901 | 2015-09-25 |
| 1437556701 | Wendy Denise Thomas | Adult Companion | 1501 13th Street Suite F, Columbus, GA 31901 | 2014-12-02 |
| 1134523996 | Danielle Elaine Berry | General Practice | Tree of Life Healthcare, 1968 North Avenue, Columbus, GA 31901 | 2014-10-22 |
| 1710239330 | Kati Michelle Turner | Pharmacist | 1800 10th Avenue, Columbus, GA 31901 | 2012-10-05 |
| Find all providers in zip 31901 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089627 | Leora A Sales | Behavior Technician | 3070 Riverside Dr, Ste 200, Columbus, Oh, Columbus, OH 43221 | 2020-10-05 |
| 1255948832 | Kayla Maree Pitzer | Behavior Technician | 1639 Bradley Park Dr Ste 500, Columbus, GA 31904-3623 | 2020-09-28 |
| 1225659055 | Nyesha Newsom | Behavior Technician | 5394 Ivywood Ln, Columbus, OH 43229-3909 | 2020-05-04 |
| 1437770708 | Erin M Beach | Behavior Technician | 3070 Riverside Dr Ste 400, Columbus, OH 43221-2547 | 2020-04-28 |
| 1790310001 | Mackenzie Ann Steitz | Behavior Technician | 3070 Riverside Dr # 200, Columbus, OH 43221-2547 | 2020-03-06 |
| 1891335352 | Dayana Banks | Behavior Technician | 3070 Riverside Dr Unit 200, Columbus, OH 43221-2547 | 2020-01-13 |
| 1730729401 | Sarah Hendricks | Behavior Technician | 2222 Poshard Dr, Columbus, IN 47203-1843 | 2020-01-10 |
| 1740821362 | Luke Marcus Ekstrom | Behavior Technician | 1349 Warren Williams Rd, Columbus, GA 31901-2630 | 2019-10-04 |
| 1972152122 | Emily Grace Rhodes | Behavior Technician | 3575 Macon Rd Ste 11, Columbus, GA 31907-8228 | 2019-09-10 |
| 1295387892 | Dewaynia Traniese Farrow | Behavior Technician | 1709 Bunker Hill Rd, Columbus, GA 31907-6719 | 2019-07-12 |
| Find all providers in COLUMBUS | ||||
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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.