DR. CHARLES BRADFORD JACKSON (NPI# 1447213996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447213996 |
| Entity Type | Individual |
| Full Name | DR. CHARLES BRADFORD JACKSON |
| Credential | MD |
| Practice Address |
2501 N Glebe Rd Suite 201 Arlington VA 22207-3558 |
| Mailing Address |
251 Bliss Ln Great Falls VA 22066-3221 |
| Practice Telephone | 7035251911 |
| Practice Fax Number | 8663006035 |
| Mailing Telephone | 7037594109 |
| Mailing Fax Number | 8663006031 |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2011-12-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
0101024618 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | CAREFIRST | CAREFIRST 3619001 | 01 |
| VA | WORKSMANS COMP | 148958700 | 01 |
| VA | 6459871 | 05 | |
| VA | BLUE CROSS | B/C 36190001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457896839 | Charles Jackson | Counselor | 2911 Penick St, Shreveport, LA 71109-4337 | 2016-12-21 |
| 1043655681 | Charles D Jackson | Driver | 4856 W.12th, Suite 1, Cleveland, OH 44109-3424 | 2013-05-09 |
| 1437594553 | Charles Jackson | Social Worker | 18712 Quarry St, Riverview, MI 48193-4527 | 2013-05-02 |
| 1508154105 | Charles Gilbert Jackson Jr. | Psychiatry & Neurology | 88 Crescent St, Northampton, MA 01060-2115 | 2011-07-16 |
| 1457669848 | Charles Edward Jackson Jr. | Psychologist | 1407 Healing Water Lane, N.las Vegas, NV 89031 | 2010-09-20 |
| 1588994081 | Charles Dustin Jackson | Counselor | 5004 Nw 26th St, Oklahoma City, OK 73127-1722 | 2010-01-05 |
| 1508985250 | Charles Arthur Jackson Jr. | Chiropractor | 2455 E Hill Rd, Grand Blanc, MI 48439 | 2007-03-27 |
| 1760535926 | Charles Jackson | Podiatrist | 820 N Dalmont St, Hobbs, NM 88240-5214 | 2007-01-19 |
| 1982769840 | Charles Jackson | Dentist | 3540 82nd St, Jackson Heights, NY 11372-5159 | 2006-12-22 |
| 1437224813 | Charles Wesley Jackson Jr. | Psychologist | 2980 Washington Blvd, Cleveland Heights, OH 44118-2450 | 2006-11-21 |
| Street Address |
2501 N GLEBE RD SUITE 201 |
| City | ARLINGTON |
| State | VA |
| Zip Code | 22207-3558 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417956814 | Mary Ellen Gallagher | Internal Medicine | 2501 N Glebe Rd, Suite 301, Arlington, VA 22207-3558 | 2005-07-18 |
| 1356974273 | Barry Johnson | Counselor | 2501 N Glebe Rd, Arlington, VA 22207-3558 | 2020-02-19 |
| 1407499783 | Christina Savoy | Nurse Practitioner | 2501 N Glebe Rd, Arlington, VA 22207-3558 | 2019-10-19 |
| 1811404429 | India Walsh | Social Worker | 2501 N Glebe Rd, Arlington, VA 22207-3558 | 2018-01-04 |
| 1457867178 | Yelena Catherine Kilgore | Social Worker | 2501 N Glebe Rd, Arlington, VA 22207-3558 | 2017-12-18 |
| 1750761276 | Arlington Guidance Associates | Social Worker | 2501 N Glebe Rd, Suite 303, Arlington, VA 22207-3558 | 2015-06-01 |
| 1114306719 | Kasie Michelle Cassell | Nurse Practitioner | 2501 N Glebe Rd, Suite 303, Arlington, VA 22207-3558 | 2015-05-28 |
| 1699012930 | Columbia Associates In Psychiatry PC | Psychiatry & Neurology | 2501 N Glebe Rd, Suite 303, Arlington, VA 22207-3558 | 2013-01-07 |
| 1023369170 | Alondra Mali Ayala Jimenez | Psychiatry & Neurology | 2501 N Glebe Rd, Arlington, VA 22207-3558 | 2012-09-28 |
| 1073787313 | Rebecca Frances Berman | Social Worker | 2501 N Glebe Rd, Suite 303, Arlington, VA 22207-3558 | 2008-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952820383 | Myrna Carlin Del Olivar | Dentist | Santa Rosalia 20380, Ste 3, Tijuana, BAJA CALIFORNIA 22207 | 2017-09-18 |
| 1770937617 | Jennifer Claire Gagnon | Nurse Practitioner | 2807 N. Glebe Road, Marymount University, Student Health, Arlington, VA 22207 | 2016-04-18 |
| 1609297308 | Henry L Danaceau, Md Ltd | Orthopaedic Surgery | 2501 North Glebe Road, Arlington, VA 22207 | 2013-12-23 |
| 1508121856 | Ashanti Sade Fludd | Home Health Aide | 5010 22nd Street, North Arlington, VA 22207 | 2012-07-11 |
| 1619204609 | Nathaniel Thomas Connally Jr. | Internal Medicine | 3563 N. Abingdon St., Arlington, VA 22207 | 2009-11-11 |
| 1548421076 | Physical Therapy Health Center | Clinic/Center | 5312 N 36th St, Arlington, VA 22207 | 2008-06-18 |
| 1770784415 | Edmund Russell Lynn Jr. | Social Worker | 6033 Little Falls Rd, Arlington, VA 22207 | 2007-05-30 |
| 1053520494 | Deborah Cusick Defranco | Specialist/Technologist | 1426 North Quincy Street, Arlington, VA 22207 | 2007-05-22 |
| 1316081284 | Denise E Bruner Md & Assoc PC | Internal Medicine | 5015 Lee Highway, Suite 201, Arlington, VA 22207 | 2007-02-16 |
| 1740340751 | Albert John Kalil | Psychologist | 4635 14th St North, Arlington, VA 22207 | 2006-12-11 |
| Find all providers in zip 22207 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295774016 | Public Hospital Dist No 1 Skagit | Orthopaedic Surgery | 328 S. Stillaguamish Ave., Arlington, WA 98223-1660 | 2006-06-06 |
| 1730168444 | Keith Meister | Orthopaedic Surgery | 3533 Matlock Rd, Arlington, TX 76015-3604 | 2006-01-11 |
| 1215431663 | Orthoone Sports Medicine & Orthopaedics, Pllc | Orthopaedic Surgery | 11851 Will Harris Dr, Arlington, TN 38002 | 2018-03-21 |
| 1952818346 | Christina Suzanne Decaro | Orthopaedic Surgery | 3533 Matlock Rd, Arlington, TX 76015-3604 | 2018-01-07 |
| 1023530342 | Olivia Mae Larussa | Orthopaedic Surgery | 1701 N George Mason Dr, Arlington, VA 22205-3610 | 2017-07-07 |
| 1902187701 | Shane T Seroyer Md Pa | Orthopaedic Surgery | 515 W Mayfield Rd Ste 116, Arlington, TX 76014-2084 | 2011-09-07 |
| 1801057179 | Lindsey Nicole Dietrich | Orthopaedic Surgery | 902 W Randol Mill Rd Ste 120, Arlington, TX 76012-2579 | 2008-06-19 |
| 1487828430 | Ronald Paik | Orthopaedic Surgery | 1715 N George Mason Dr, Suite 504, Arlington, VA 22205-3609 | 2008-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831751148 | Sideline Orthopedics and Sports Medicine, LLC | Orthopaedic Surgery | 125 Akers Farm Rd Ste C&d, Christiansburg, VA 24073-4866 | 2019-07-08 |
| 1881171718 | Franklin Clinic Corp | Orthopaedic Surgery | 210 Fairview Dr Ste A, Franklin, VA 23851-1216 | 2018-07-24 |
| 1932638921 | Sideline Orthopedics and Sports Medicine, LLC | Orthopaedic Surgery | 1787 W. Lee Hwy, Forest Medical Park, Unit B, Bldg 2, Wytheville, VA 24382-1437 | 2017-06-05 |
| 1477956878 | Virginia Commonwealth University | Orthopaedic Surgery | 821 W Franklin St, Richmond, VA 23284-9012 | 2014-09-30 |
| 1871920132 | Mark T Wolfe | Orthopaedic Surgery | 3906 Breezeport Way, Apt 105, Suffolk, VA 23435-1080 | 2013-10-02 |
| 1750724167 | Ryan Austin Harrell | Orthopaedic Surgery | 5818 Harbour View Blvd Ste 150d, Suffolk, VA 23435-3327 | 2013-04-16 |
| 1306088687 | Nathan William Coleman | Orthopaedic Surgery | 13350 Franklin Farm Rd Ste 220, Herndon, VA 20171-4095 | 2009-04-01 |
| 1497923288 | Ryan Glenn Miyamoto | Orthopaedic Surgery | 3620 Joseph Siewick Dr Ste 201, Fairfax, VA 22033-1758 | 2008-02-14 |
| 1467662791 | Stephen F. Brockmeier | Orthopaedic Surgery | 515 Ray C Hunt Dr Ste 1100, Charlottesville, VA 22903-2981 | 2007-05-23 |
| 1386706620 | David R. Diduch | Orthopaedic Surgery | 515 Ray C. Hunt Dr, Charlottesville, VA 22903-2981 | 2006-12-14 |
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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.