JESSICA S JACKSON DPM PLLC (NPI# 1558516054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558516054 |
Entity Type | Organization |
Organization Name | JESSICA S JACKSON DPM PLLC |
Practice Address |
15014 Bircham Rd Louisville KY 40245-4104 |
Mailing Address |
6200 Pleasant Ave Suite 3 Fairfield OH 45014-4670 |
Practice Telephone | 5025580194 |
Mailing Telephone | 5138299333 |
Mailing Fax Number | 5138587827 |
Enumeration Date | 2008-11-25 |
Last Update Date | 2016-03-22 |
Authorized Official Name | JESSICA JACKSON (DPM) |
Authorized Official Telephone | 5025580194 |
Authorized Official Credential | DPM |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213E00000X | Podiatrist | 00242 | KY | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KY | 7100071060 | 05 | |
KY | RAILROAD MEDICARE | DO6474 | 01 |
IN | 201083640A | 05 |
Street Address |
15014 BIRCHAM RD |
City | LOUISVILLE |
State | KY |
Zip Code | 40245-4104 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083247753 | Stepping Stones Pediatric Therapy, LLC | Early Intervention Provider Agency | 330 Cranbury Way, Louisville, KY 40245 | 2020-02-20 |
1790324333 | Joseph Strano | Pharmacist | 12450 Lagrange Road, Louisville, KY 40245 | 2019-12-30 |
1174160725 | Anne S Hill | Technician | 16621 Taunton Vale Rd, Louisville, KY 40245 | 2019-12-03 |
1750808937 | Amy Judy | Assistant Behavior Analyst | 4512 Meadowlark Manor Dr, Louisville, KY 40245 | 2017-08-28 |
1104356567 | Mmr Cardiovascular Consulting LLC | Internal Medicine | 1101 Glenlake Way, Louisville, KY 40245 | 2017-06-18 |
1952830135 | Staci Marie Trofimov | Dietitian, Registered | 13008 Willow Forest Drive, Louisville, KY 40245 | 2017-06-09 |
1629524913 | Forefront Dermatology, S.c. | Dermatology | 159 S. English Station Road, Louisville, KY 40245 | 2016-08-28 |
1861867830 | Jamila Hadden | Counselor | 111 Parkview Dr., Louisville, KY 40245 | 2015-12-02 |
1538570312 | Brian Johnson | Case Manager/Care Coordinator | 4717 Middlesex Drive, 4717 Middlesex Drive, Louisville, KY 40245 | 2014-05-14 |
1033535828 | Genesis Eldercare Physician Services LLC | Nurse Practitioner | 16605 Chestnut Glen Pl, Louisville, KY 40245 | 2014-03-17 |
Find all providers in zip 40245 |
Taxonomy Code | 213E00000X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578112983 | Peter Cunningham | Podiatrist | 1 Audubon Plaza Dr Ofc L2, Louisville, KY 40217-1318 | 2019-09-09 |
1447787676 | Jenna Vaught LLC | Podiatrist | 3407 Kerry Dr, Louisville, KY 40218-2131 | 2017-05-18 |
1083907471 | Larry K Ketcherside | Podiatrist | 9110 Leesgate Rd, Louisville, KY 40222-5053 | 2011-05-18 |
1568625903 | Janine A. Valentino | Podiatrist | 9880 Angies Way Suite 110, Louisville, KY 40241-2943 | 2008-07-07 |
1205055332 | Achillies Foot and Ankle Center Inc | Podiatrist | 317 B Gutherie Green, Louisville, KY 40202 | 2007-04-25 |
1932277274 | John M Miller | Podiatrist | 335 W South Boulder Road, Suite 5, Louisville, CO 80027-1192 | 2006-12-04 |
1366542748 | Steven Richard Shlonsky | Podiatrist | 149 Thierman Lane, Louisville, KY 40207 | 2006-09-25 |
1841397320 | Family Foot and Ankle Care Pllc | Podiatrist | 130 N Evergreen Rd, Suite 102, Louisville, KY 40243-1489 | 2006-09-19 |
1497772255 | Jeffrey Kenneth Marzian | Podiatrist | 3403 Gatecreek Rd, Louisville, KY 40272-2687 | 2006-07-17 |
1912947631 | Jessica Jackson | Podiatrist | 178 N Ewing Ave, Louisville, KY 40206-2459 | 2006-06-08 |
Find all providers in LOUISVILLE |
City | LOUISVILLE |
Zip Code | 40245 |
Please comment or provide details below to improve the information on JESSICA S JACKSON DPM PLLC.
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.