DR. GAIL COLE JACKSON (NPI# 1417165531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417165531 |
| Entity Type | Individual |
| Full Name | DR. GAIL COLE JACKSON |
| Credential | M.D. |
| Practice Address |
100 Myrtle Blvd Gracewood GA 30812-1500 |
| Practice Telephone | 7067902160 |
| Mailing Telephone | 7067902160 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 020860 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811324387 | Gail Jackson | Behavioral Analyst | 9030 W Sahara Ave # 193, Las Vegas, NV 89117-5744 | 2013-09-30 |
| 1417037185 | Gail M Jackson | Counselor | Belmont Center, 4200 Monument Road, Philadelphia, PA 19131 | 2006-10-17 |
| 1104817303 | Gail E Jackson | Counselor | 625 Truman St Ne, Albuquerque, NM 87110-6443 | 2005-11-04 |
| 1154823193 | Gail Jackson | Technician | 1455 E Tropicana Ave Ste 175a, Las Vegas, NV 89119-6507 | 2018-03-06 |
| 1407057003 | Gail Allsup Jackson | Marriage & Family Therapist | 1770 E 118th St, Los Angeles, CA 90059-2518 | 2007-05-30 |
| 1083838114 | Gail Jackson | Social Worker | 10 Bridge St, The Simpson Block, Lowell, MA 01852-1201 | 2007-04-12 |
| 1063401958 | Gail N Jackson | Obstetrics & Gynecology | 8635 W 3rd St, Suite 680 West, Los Angeles, CA 90048-6101 | 2005-10-14 |
| Street Address |
100 MYRTLE BLVD |
| City | GRACEWOOD |
| State | GA |
| Zip Code | 30812-1500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639166234 | Ga Department of Human Resources | Skilled Nursing Facility | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2005-09-29 |
| 1104330398 | Sopheap Pin | Pharmacist | 100 Myrtle Blvd, Dept of Pharmacy, Gracewood, GA 30812 | 2017-11-27 |
| 1427434273 | Cynthia Bass Kucela | Pharmacist | 100 Myrtle Blvd, East Central Regional Hospital Dept of Pharmacy, Gracewood, GA 30812 | 2015-08-04 |
| 1013391119 | Hasim Momin | Dentist | 100 Myrtle Blvd, Gracewood, GA 30812 | 2015-07-17 |
| 1629463864 | Inoka Abeysiri Devapriya | Surgery | 100 Myrtle Blvd, 103b, Gracewood, GA 30812 | 2015-04-04 |
| 1962720664 | Eliza A Myers | Dentist | 100 Myrtle Blvd, East Central Regional Hospital, Gracewood, GA 30812 | 2010-05-06 |
| 1992036909 | Department of Behavioral Health and Developmental Disabilities | Pharmacy | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2010-01-15 |
| 1699000703 | Department of Behavioral Health and Developmental Disabilities | Intermediate Care Facility, Mentally Retarded | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2009-10-07 |
| 1053646166 | Department of Behavioral Health and Developmental Disabilities | Skilled Nursing Facility | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2009-10-07 |
| 1982818845 | East Central Regional Hospital | Psychiatric Hospital | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2007-05-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932571312 | Holli E Pender | Pharmacist | 100 Myrtle Blvd., Gracewood, GA 30812 | 2015-10-26 |
| 1295163277 | Melissa B Lynch | Contractor | 1523 Keron Way, Gracewood, GA 30812 | 2013-10-29 |
| 1043822067 | Marla Marie Mitcham | Pharmacist | 100 Myrtle Blvd., Pharmacy Bldg. 15 Room G12, Gracewood, GA 30812 | 2020-08-20 |
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083704712 | Denise W Smith | Pediatrics | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2006-10-13 |
| 1235226986 | Terri E Lawless | Pediatrics | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063025690 | Sas Medical LLC | Pediatrics | 8601 Dunwoody Pl Ste 565, Sandy Springs, GA 30350-2519 | 2020-08-24 |
| 1467063248 | Kindercare Pediatrics of Georgia | Pediatrics | 174 Royal Oak Dr, Guyton, GA 31312-5624 | 2020-08-13 |
| 1649880667 | Grayson Pediatrics Mobile | Pediatrics | 297 Cooper Rd Ste B, Loganville, GA 30052-2518 | 2020-08-04 |
| 1134745953 | Molly C Shields | Pediatrics | Dugas Building Bg 107 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-17 |
| 1033734918 | Lauren Wooten Smith | Pediatrics | Chog Pediatric Residency Program 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-16 |
| 1225667314 | Moyosore Mary Abere | Pediatrics | 104 Bluff Chase, Bonaire, GA 31005-3867 | 2020-04-02 |
| 1447886155 | Natalie Brown Shumate | Pediatrics | 1669 Pleasant Valley Rd Ne, Monroe, GA 30655-6211 | 2020-03-14 |
| 1356988455 | Maura Mchugh Barrett | Pediatrics | 1805 Parke Plaza Cir Ste 103, Stone Mountain, GA 30087-3646 | 2019-12-08 |
| 1629614060 | Kaley Adams | Pediatrics | 227 Torrington Blvd, Thomasville, GA 31757-3904 | 2019-11-20 |
| 1164066791 | Holly Savino | Pediatrics | 603 Old Norcross Rd Ste A, Lawrenceville, GA 30046-4315 | 2019-11-06 |
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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.