CAROLE LYNN JACKSON (NPI# 1427020882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427020882 |
| Entity Type | Individual |
| Full Name | CAROLE LYNN JACKSON |
| Credential | MD |
| Practice Address |
525 Western Avenue Suite 303 Conway AR 72034-6135 |
| Mailing Address |
2519 College Avenue Conway AR 72034-6135 |
| Practice Telephone | 5013279497 |
| Practice Fax Number | 5013273478 |
| Mailing Telephone | 5013276547 |
| Mailing Fax Number | 5013279715 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2011-06-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | C 5812 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DRUG ENFORCEMENT ADMINIST | AK9193246 | 01 | |
| AR | 113505001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023359361 | Carole Anne Jackson | Psychologist | 1200 Helen Ave, N Las Vegas, NV 89030-3721 | 2013-03-12 |
| 1053546184 | Carole Ina Jackson | Counselor | 1337 Gusdorf Road, Suite E, Taos, NM 87571 | 2009-05-19 |
| Street Address |
525 WESTERN AVENUE SUITE 303 |
| City | CONWAY |
| State | AR |
| Zip Code | 72034-6135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563758 | Shelby M Perez | Case Manager/Care Coordinator | 3240 Stermer Rd, Conway, AR 72034 | 2019-08-16 |
| 1467932772 | Faith J Parfait | Licensed Practical Nurse | 1352 Watkins St, Conway, AR 72034 | 2018-08-16 |
| 1043790611 | David Adam Steinfeld | Nurse Practitioner | 855 S German Ln Ste 1, Conway, AR 72034 | 2018-08-14 |
| 1245728484 | Conway Behavioral Health, LLC | Psychiatry & Neurology | 2255 Sturgis Rd, Conway, AR 72034 | 2018-04-24 |
| 1972007292 | Eldercare of Arkansas IIi, Inc. | Assisted Living Facility | 1306 S. Donaghey, Conway, AR 72034 | 2018-03-21 |
| 1528561404 | Kouhei Kobayashi | Specialist/Technologist | 2201 Moix Blvd., Apt. 908, Conway, AR 72034 | 2018-03-16 |
| 1780191015 | Sydnie Thessing | Nurse Practitioner | 605 Dave Ward Drive #105, Conway, AR 72034 | 2018-01-09 |
| 1508371865 | Ebony Latreace Charleston | Case Manager/Care Coordinator | 3240 Stermer Road, Conway, AR 72034 | 2017-12-08 |
| 1689190647 | Denise Annette Aikman | Dentist | 1210 Hogan Lane, Suite 200, Conway, AR 72034 | 2017-08-21 |
| 1134669138 | Hortons Orthotic Lab, Inc. | Prosthetic/Orthotic Supplier | 635 Dave Ward, Suite 103, Conway, AR 72034 | 2017-02-24 |
| Find all providers in zip 72034 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184233173 | Bryan D Fuller Md Pa | Obstetrics & Gynecology | 625 United Dr Ste 330, Conway, AR 72032-7828 | 2020-07-27 |
| 1538402839 | Kathleen Turek Dunn | Obstetrics & Gynecology | 2376 Cypress Cir Ste 200, Conway, SC 29526-8994 | 2013-04-04 |
| 1346501020 | Curtis James Boyd IIi | Obstetrics & Gynecology | 625 United Dr Ste 360, Conway, AR 72032 | 2012-05-30 |
| 1417247628 | Jessica Adams Pullen | Obstetrics & Gynecology | 625 United Dr Ste 420, Conway, AR 72032-7826 | 2011-04-10 |
| 1124225321 | Henry Augustine Gonzales | Obstetrics & Gynecology | 2376 Cypress Cir Ste 203, Conway, SC 29526-8994 | 2007-06-29 |
| 1912118944 | Joshua L. Ward | Obstetrics & Gynecology | 2200 Ada Ave., Suite 301, Conway, AR 72034-4986 | 2007-05-24 |
| 1093930885 | Reginald Forrest Daves | Obstetrics & Gynecology | 2345 Steep Landing Rd, Conway, SC 29526-7833 | 2007-04-16 |
| 1134167158 | Coastal Carolina Ob Gyn LLC | Obstetrics & Gynecology | 620 Singleton Ridge Rd, Conway, SC 29526-9154 | 2006-06-02 |
| 1902869696 | Terry B Levenson | Obstetrics & Gynecology | 8004 Myrtle Trace Dr, Conway, SC 29526-8945 | 2006-04-11 |
| 1013988609 | Keitha Dewitt Holland | Obstetrics & Gynecology | 2180 Ada Avenue, Suite 300, Conway, AR 72034-7203 | 2006-01-31 |
| Find all providers in CONWAY | ||||
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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.