ANTHONY H JACKSON (NPI# 1518058676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518058676 |
| Entity Type | Individual |
| Full Name | ANTHONY H JACKSON |
| Credential | MD |
| Practice Address |
50 Wason Ave 1st Floor Springfield MA 01107-1274 |
| Mailing Address |
280 Chestnut St 2nd Floor Springfield MA 01199-1001 |
| Practice Telephone | 4137945437 |
| Practice Fax Number | 4137948901 |
| Mailing Telephone | 4137945700 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2017-12-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
43531 | MA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689287328 | Anthony Benedict Jackson | Nurse Practitioner | 8 Radford St # 202, Christiansburg, VA 24073-3320 | 2020-08-24 |
| 1558741652 | Anthony Jackson | Case Manager/Care Coordinator | 2000 Nw 1st St, Boynton Beach, FL 33435-2286 | 2015-06-03 |
| 1922410448 | Anthony Jerome Jackson | Counselor | 1826 Chelsea Rd, Elkins Park, PA 19027-1056 | 2014-06-02 |
| 1245307073 | Anthony Jackson | Counselor | 2237 River Plaza Dr, Sacramento, CA 95833-3836 | 2006-11-29 |
| 1396838868 | Anthony Haig Jackson | Psychiatry & Neurology | 31 Woodlawn Avenue, Needham, MA 02492 | 2006-10-02 |
| 1346254596 | Anthony D Jackson | Dentist | 512 E Alexander St, Plant City, FL 33563-7165 | 2006-07-27 |
| 1720024847 | Anthony L Jackson IIi | Emergency Medicine | 2575 E Bidwell St Ste 160, Folsom, CA 95630-6446 | 2006-06-20 |
| 1568077535 | Anthony Jackson | Chore Provider | 332 S Decatur Blvd, Las Vegas, NV 89107-2804 | 2020-09-15 |
| 1487210399 | Anthony Jackson | Counselor | 5080 Florence Rd, Murfreesboro, TN 37129-2922 | 2019-05-15 |
| 1063076925 | Anthony Earle Jackson | Student in an Organized Health Care Education/Training Program | 3901 Rainbow Blvd, Kansas City, KS 66160-8500 | 2019-04-26 |
| Street Address |
50 WASON AVE 1ST FLOOR |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107-1274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265413009 | Anastasios G Angelides | Pediatrics | 50 Wason Ave, 1st Fl, Springfield, MA 01107-1274 | 2005-11-09 |
| 1932727203 | Georgianna Rose Shea | Nurse Practitioner | 50 Wason Ave, 1st Fl, Springfield, MA 01107-1274 | 2020-07-13 |
| 1588118350 | Courtney Manning | Genetic Counselor, MS | 50 Wason Ave, Springfield, MA 01107-1274 | 2016-08-10 |
| 1457708455 | Samantha Mccarthy | Dietitian, Registered | 50 Wason Ave, Springfield, MA 01107-1274 | 2016-05-19 |
| 1881057800 | Baystate Developmental Behavioral Pediatrics | Psychologist | 50 Wason Ave, 1st. Floor, Springfield, MA 01107-1274 | 2016-03-29 |
| 1912370438 | Brenda Peters | Behavioral Analyst | 50 Wason Ave, Springfield, MA 01107-1132 | 2015-11-05 |
| 1053795351 | Shayl Griffith | Student in an Organized Health Care Education/Training Program | 50 Wason Ave, Springfield, MA 01107-1132 | 2015-07-16 |
| 1043620859 | Lisa Laprade | Dietitian, Registered | 50 Wason Ave, 1st Floor, Springfield, MA 01107-1132 | 2014-05-01 |
| 1245650225 | Baystate Pharmacy | Pharmacy | 50 Wason Ave, Springfield, MA 01107-1132 | 2014-04-17 |
| 1669898565 | Ruth Kurniawati | Physician Assistant | 50 Wason Ave, Springfield, MA 01107-1132 | 2014-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740702547 | Domingo Nieves Jr. | Counselor | 2225 Main St., Springfield, MA 01107 | 2017-07-13 |
| 1801318266 | Denise Lawson | Counselor | 2257 Main Street, Springfield, MA 01107 | 2017-07-07 |
| 1568912491 | Trina Cysz | Nurse Practitioner | 101 Wason Avenue, Commonwealth Care Alliance, Springfield, MA 01107 | 2016-10-04 |
| 1609322262 | Toheeb Oladimeji Bakare | Counselor | 322 Birnie Avenue, Springfield, MA 01107 | 2016-09-01 |
| 1952701161 | Jalissa Sostre | Counselor | 32 Abbe Ave, Springfield, MA 01107 | 2014-08-26 |
| 1659799161 | Elizabeth A. Otmaskin | Obstetrics & Gynecology | 3455 Main Street Suite C, Baysttate Ob Gyn Group Inc, Springfield, MA 01107 | 2014-04-01 |
| 1205268885 | Catherine Matejcek Davies | Counselor | 246 Park Street, Springfield, MA 01107 | 2013-08-06 |
| 1750723268 | Jasdeep S. Badwal | Allergy & Immunology | 2 Medical Center Dr Ste 406, Springfield, MA 01107 | 2013-07-25 |
| 1255691846 | Medical Express Urgent Care Center, Co. Inc. | Physical Medicine & Rehabilitation | 438 Chestnut Street, Springfield, MA 01107 | 2012-05-17 |
| 1205166642 | Matthew R Kelley | Audiologist | 100 Wason, Suite 100, Springfield, MA 01107 | 2010-01-07 |
| Find all providers in zip 01107 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205810082 | Michael R Pranzatelli | Psychiatry & Neurology | Southern Illinois University Healthcare Administration, Springfield, IL 62794 | 2005-12-05 |
| 1619382645 | Dusit Adstamongkonkul | Psychiatry & Neurology | 1000 E Primrose St Ste 200, Springfield, MO 65807 | 2014-06-28 |
| 1700146792 | Adam J David | Psychiatry & Neurology | 50 Wason Avenue, Springfield, MA 01107-1274 | 2012-05-23 |
| 1619289311 | Jacqueline A. Hauer | Psychiatry & Neurology | 1965 S Fremont Ave, Suite 130, Springfield, MO 65804-2201 | 2010-07-10 |
| 1023246600 | Jeffrey Russell Frank | Psychiatry & Neurology | 1 Hayden Bridge Way, Springfield, OR 97477-9747 | 2009-06-23 |
| 1811105331 | James J Collins | Psychiatry & Neurology | 1965 S Fremont Ave Ste 130, Springfield, MO 65804-2252 | 2007-05-18 |
| 1366562159 | David C Dredge | Psychiatry & Neurology | 50 Wason Ave, 1st Fl, Springfield, MA 01107-1274 | 2007-03-29 |
| 1033200944 | Beth A. Rosen | Psychiatry & Neurology | 50 Wason Avenue, 1st Floor, Springfield, MA 01107-1274 | 2006-09-27 |
| 1255315065 | Theodore R Sunder | Psychiatry & Neurology | 421 N 9th St, Springfield, IL 62702-5317 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366963258 | Maria Antonietta Mazzola | Psychiatry & Neurology | 57 Manchester Rd, Brookline, MA 02446 | 2017-06-29 |
| 1548508252 | Adriana Mendez Sanchez | Psychiatry & Neurology | 771 Albany Street Boston Medical Center Child Neurology, Dowling 3 South Rm 3314, Boston, MA 02118 | 2013-01-30 |
| 1083909774 | Kristen A. Lindgren | Psychiatry & Neurology | Nwh Pediatric Ambulatory Care Center, 2014 Washington St, 6 South, Newton, MA 02462 | 2011-06-10 |
| 1124082714 | Rebeca N Alvareza-altalef | Psychiatry & Neurology | 750 Washington St # 330, Boston, MA 02111-1526 | 2006-04-12 |
| 1982670535 | Elizabeth Anne Thiele | Psychiatry & Neurology | 55 Fruit St Yaw 6b, Pediatric Neurology, Boston, MA 02114 | 2006-02-24 |
| 1205480043 | Lauren Sham | Psychiatry & Neurology | 300 Longwood Ave, Boston, MA 02115-5724 | 2019-07-30 |
| 1457848293 | Paul N. Chervin, M.d. LLC | Psychiatry & Neurology | 604 Main Street, Woburn, MA 01801 | 2018-04-17 |
| 1386164101 | Ashley Weng | Psychiatry & Neurology | 800 Washington St, Boston, MA 02111 | 2017-06-22 |
| 1922554872 | Kristen Lindgren Md Phd LLC | Psychiatry & Neurology | 2014 Washington St, Newton-wellesley Hospital, Pediatric Ambulatory Clinic, Newton, MA 02462-1607 | 2016-08-31 |
| 1891148854 | Jose Ildefonso Rodriguez Moreno | Psychiatry & Neurology | 800 Washington St, Boston, MA 02111-1552 | 2016-07-14 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 01107 |
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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.