JOHN ERIC JACKSON (NPI# 1558653725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558653725 |
| Entity Type | Individual |
| Full Name | JOHN ERIC JACKSON |
| Credential | M.D. |
| Practice Address |
1985 Jefferson Davis Hwy Fredericksburg VA 22401-6233 |
| Practice Telephone | 5403736647 |
| Practice Fax Number | 5404791656 |
| Mailing Telephone | 5403736647 |
| Mailing Fax Number | 5404791656 |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2020-06-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
0101268114 | VA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801439799 | John Archie Jackson Jr. | Counselor | 209 Martin Luther King Dr, Elizabethtown, NC 28337 | 2019-10-23 |
| 1063073310 | John Jackson | Speech-Language Pathologist | 2143 Mohawk Trl, Maitland, FL 32751-3950 | 2019-06-27 |
| 1992202832 | John Jackson | Physical Therapy Assistant | 209 Lake St, Chittenango, NY 13037-1518 | 2018-04-08 |
| 1063911105 | John Martin Jackson | Physical Therapy Assistant | 11118 Lantern Way, North Chesterfield, VA 23236-3575 | 2018-02-05 |
| 1184164493 | John Jackson | Emergency Medical Technician, Paramedic | 137 S Newport Ave, Newport, WA 99156-1942 | 2017-03-06 |
| 1508236837 | John Willard Jackson | Anesthesiology | 7857 Caruth Ct, Dallas, TX 75225-8133 | 2015-09-29 |
| 1043572035 | John Ferndale Jackson | Behavioral Analyst | 931 Azure Heights Place, Las Vegas, NV 89110 | 2012-06-14 |
| 1679830558 | John Michael Jackson | Pharmacist | 1000 Castlebay, Cincinnati, OH 45245-4910 | 2012-04-18 |
| 1013043553 | John Phillip Jackson | Occupational Therapist | 7810 Avenue U Apt B, Lubbock, TX 79423-2430 | 2007-02-26 |
| 1275673451 | John W Jackson | Pharmacist | 1667 Bellemeade Dr, Altoona, PA 16602-7402 | 2007-02-07 |
| Street Address |
1985 JEFFERSON DAVIS HWY |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-6233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548475189 | Connor A Patterson | Dermatology | 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-6233 | 2007-05-14 |
| 1437686375 | Kristen Helene Keller | Physician Assistant | 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-6233 | 2017-05-22 |
| 1023497880 | Jalal Alghabra | Physician Assistant | 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-6233 | 2015-05-27 |
| 1740673250 | Leah Waller | Physician Assistant | 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-6233 | 2015-03-07 |
| 1598056582 | Virginia Dermatology and Skin Surgery Center | Dermatology | 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-5298 | 2011-04-25 |
| 1861695181 | Mark P. Eid | Dermatology | 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-5298 | 2007-06-06 |
| 1487855680 | Kim D Edhegard | Dermatology | 1985 Jefferson Davis Hwy, Fredericksburg, VA 22401-6233 | 2007-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1265074231 | Anna Kelleher | Behavior Technician | 1411 Princess Anna St, Frericksburg, VA 22401 | 2019-10-11 |
| 1649824152 | Zaan Z Ali | Audiologist | 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 | 2019-08-01 |
| 1790342426 | Michael Williams Jr. | Physician Assistant | 411 B Park Hill Dr, Frederickburg, VA 22401 | 2019-05-29 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1922579630 | Primary and Urgent Care LLC | Family Medicine | Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 | 2018-12-07 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053407452 | Theresa Conologue | Dermatology | 1101 Sam Perry Blvd Ste 121, Fredericksburg, VA 22401-4465 | 2006-10-04 |
| 1609851609 | Patricia P Stevens | Dermatology | 1300 Thornton St, Fredericksburg, VA 22401-4654 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225343262 | Mary Francis Hunter | Dermatology | 100 2nd St Nw, Charlottesville, VA 22902-5193 | 2010-08-14 |
| 1932426418 | Patricia Lucey | Dermatology | 8100 Boone Blvd, Suite 300, Vienna, VA 22182-4621 | 2010-04-23 |
| 1265635114 | Bridget M Bryer | Dermatology | 215 Wayles Ln Ste 150, Charlottesville, VA 22911-4631 | 2007-06-07 |
| 1083708655 | Hoang Nguyen Pham | Dermatology | 4326 Evergreen Lane, Suite A, Annandale, VA 22003 | 2006-10-03 |
| 1407867500 | Chauncey A. Mchargue | Dermatology | 1100 Sunset Ln, Suite 1212, Culpeper, VA 22701-3307 | 2006-08-11 |
| 1922049006 | Center for Skin Surgery Pllc | Dermatology | 8301 Old Court House Rd, Vienna, VA 22182 | 2006-06-09 |
| 1952387060 | Martin S Horn | Dermatology | 10721 Main Street, Suite 3100, Fairfax, VA 22030-6906 | 2005-12-20 |
| 1922005537 | Linda Park Nims | Dermatology | 243 Church St Nw, Suite 200 C, Vienna, VA 22180-4434 | 2005-06-29 |
| 1023550654 | James River Dermatology Pllc | Dermatology | 6372 Mechanicsville Tpke Ste 103, Mechanicsville, VA 23111 | 2016-11-14 |
| 1417400763 | Monica Ka Yi Li | Dermatology | 125 Market St, Virginia Beach, VA 23462-6794 | 2016-08-03 |
| Find all providers with the same taxonomy | ||||
| City | FREDERICKSBURG |
| Zip Code | 22401 |
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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.