DR. STEPHEN W JACKSON (NPI# 1386609808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386609808 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN W JACKSON |
| Credential | M.D. |
| Practice Address |
400 Berywood Trl Nw Suite B Cleveland TN 37312-5287 |
| Practice Telephone | 4234723201 |
| Practice Fax Number | 4234764949 |
| Mailing Telephone | 4234723201 |
| Mailing Fax Number | 4234764949 |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2007-10-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | MD017093 | TN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275926503 | Stephen Jackson | Spec/Tech, Cardiovascular | 2577 Sawgrass Lake Ct, Cape Coral, FL 33909-2935 | 2015-03-11 |
| 1750636288 | Stephen Michael Jackson | Dentist | 350 E 600 S Ste 1, St George, UT 84770 | 2012-07-20 |
| 1548428964 | Stephen Daniel Jackson | Obstetrics & Gynecology | 1091 Kirkpatrick Road, Burlington, NC 27215-9714 | 2008-06-02 |
| 1164411013 | Stephen J Jackson | Emergency Medicine | 4716 S 14th St, Abilene, TX 79605-4733 | 2005-10-13 |
| 1285102582 | Stephen Lee Jackson | Marriage & Family Therapist | 5409 Maryland Way Ste 305, Brentwood, TN 37027-1035 | 2018-11-05 |
| 1225531296 | Stephen A Jackson | Social Worker | 2501 N 3rd St, Harrisburg, PA 17110-2098 | 2018-03-15 |
| 1659733491 | Stephen Jackson | Emergency Medicine | 1170 Cleveland Ave, East Point, GA 30344-3615 | 2016-03-22 |
| 1275918401 | Stephen Jackson | Physical Therapist | 36501 Mission St, Suite A, Prairieville, LA 70769-3289 | 2015-07-29 |
| 1295097590 | Stephen Jackson | Counselor | 165 Roanoke Rd, El Cajon, CA 92020-4015 | 2012-06-12 |
| 1417087107 | Stephen Charles Jackson | Chiropractor | 122 N 2nd St, Millville, NJ 08332-6512 | 2007-03-06 |
| Street Address |
400 BERYWOOD TRL NW SUITE B |
| City | CLEVELAND |
| State | TN |
| Zip Code | 37312-5287 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164421483 | James L Marcum | Internal Medicine | 400 Berywood Trl Nw, Suite A, Cleveland, TN 37312-5287 | 2005-07-19 |
| 1538173232 | Tenn Valley Urology Cente | Urology | 400 Berywood Trl Nw, Ste B, Cleveland, TN 37312-5288 | 2006-07-28 |
| 1184689788 | Edward M Mcintire Jr. | Urology | 400 Berywood Trl Nw, Suite B, Cleveland, TN 37312-5287 | 2006-04-18 |
| 1881658664 | Christopher C Thacker | Urology | 400 Berywood Trl Nw, Suite B, Cleveland, TN 37312-5287 | 2006-04-17 |
| 1376517557 | Robert J Mills | Internal Medicine | 400 Berywood Trl Nw, Suite A, Cleveland, TN 37312-5287 | 2006-02-15 |
| 1740289073 | Joseph K Powers | Internal Medicine | 400 Berywood Trl Nw, Suite A, Cleveland, TN 37312-5287 | 2005-07-19 |
| 1538168893 | Brian C Mitchell | Internal Medicine | 400 Berywood Trl Nw, Suite A, Cleveland, TN 37312-5287 | 2005-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041196 | Middle Tennessee Treatment Clinics, LLC | Clinic/Center | 3575 Keith Street Nw, Cleveland, TN 37312 | 2020-10-22 |
| 1922630870 | Samuel Anthony Pharr | Physical Therapist | 1090 Tasso Lane, Ne, Cleveland, TN 37312 | 2020-02-09 |
| 1508400235 | Paul E. Pinson | Anesthesiology | 3917 Georgetown Road, Nw, Cleveland, TN 37312 | 2019-11-06 |
| 1902456114 | Brittani P Munck | Technician | 147 Gable Dr Nw, Cleveland, TN 37312 | 2019-09-19 |
| 1053975243 | Christian Joy Mcgirt | Counselor | 4160 North Ocoee Street, Suite 8, Cleveland, TN 37312 | 2019-04-24 |
| 1629558812 | Back In Motion, Inc. | Chiropractor | 3771 Georgetown Rd. Nw, Cleveland, TN 37312 | 2018-08-16 |
| 1508342221 | Andre L James | Case Manager/Care Coordinator | 2600 Executive Drive, Cleveland, TN 37312 | 2018-07-16 |
| 1386152197 | Courtney Ferguson | Behavioral Analyst | 3505 Adkisson Dr Nw Ste 166, Cleveland, TN 37312 | 2018-01-15 |
| 1669992285 | Nurseprofessionals | Licensed Practical Nurse | 2901 Peerless Road, Cleveland, TN 37312 | 2017-06-24 |
| 1407383334 | I Care Eyecare LLC | Optometrist | 5546 Keith St. Ne, Walmart Vision Center, Cleveland, TN 37312 | 2017-05-23 |
| Find all providers in zip 37312 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194232876 | Nathan Ying-ho Hoy | Urology | 9500 Euclid Ave, Q10, Cleveland, OH 44195 | 2018-01-04 |
| 1750808580 | Clyde Alexander Kyle | Urology | 448 Kyle Ln Nw, Cleveland, TN 37312-6435 | 2017-08-23 |
| 1144607508 | Johnathan Doolittle | Urology | 2050 E 96th St Q Building, Cleveland, OH 44195-3548 | 2015-05-05 |
| 1427374974 | Jessica Helen Hannick | Urology | 11100 Euclid Ave # Rbc2311, Cleveland, OH 44106 | 2010-04-08 |
| 1073836623 | Juan Antonio Jimenez | Urology | 18099 Lorain Ave Ste 141, Cleveland, OH 44111-5611 | 2010-03-10 |
| 1851550321 | Georges-pascal Haber | Urology | 9500 Euclid Ave /a100, Cleveland Clinic - Urology, Cleveland, OH 44195 | 2008-06-09 |
| 1699947333 | Anil Abraham Thomas | Urology | Glickman Urological Institute A100, Cleveland Clinic Foundation, Cleveland, OH 44195-0001 | 2008-04-01 |
| 1487826244 | Matthew Neil Simmons | Urology | Cleveland Clinic - Glickman Urological Institute, 9500 Euclid Ave A100, Cleveland, OH 44195-0001 | 2008-04-01 |
| 1588833305 | Hadley Merrideth Wood | Urology | Glickman Urological Institute/a100, 9500 Euclid Avenue, Cleveland, OH 44195-0001 | 2008-02-26 |
| 1982751921 | Grant Pegram Simmons | Urology | 400 Berywood Trl Nw Ste B, Cleveland, TN 37312-5288 | 2007-01-04 |
| Find all providers in CLEVELAND | ||||
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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.