MR. LARRY ARTHUR JACKSON (NPI# 1578880548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578880548 |
| Entity Type | Individual |
| Full Name | MR. LARRY ARTHUR JACKSON |
| Credential | M.D. |
| Practice Address |
1445 Gateway Blvd Cottage Grove OR 97424-1224 |
| Mailing Address |
Po Box 607 Cottage Grove OR 97424-0026 |
| Practice Telephone | 5419427000 |
| Practice Fax Number | 5419425550 |
| Mailing Telephone | 5419427000 |
| Mailing Fax Number | 5419425550 |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2010-04-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD08513 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568855724 | Larry Jackson Jr. | Specialist/Technologist | 826 Warfield Pl, Lexington, KY 40505-3612 | 2015-03-12 |
| 1396186276 | Larry Tyler Jackson | Dentist | 14100 N 83rd Ave, Ste 280, Peoria, AZ 85381-5658 | 2013-07-08 |
| 1093878191 | Larry Randolph Jackson | Registered Nurse | 615 Rapids Rd, Columbia, SC 29212-3024 | 2006-12-19 |
| 1710068499 | Larry M. Jackson | Nutritionist | 9357 S Kingston Ave, Chicago, IL 60617-4042 | 2006-10-18 |
| 1093169062 | Larry Jackson Jr. | Counselor | 1420 Central Ave, Dubuque, IA 52001-4842 | 2016-04-15 |
| 1679971667 | Larry Jackson | Specialist | 1501 5th Ave N, St Petersburg, FL 33705-2008 | 2014-12-08 |
| 1023285582 | Larry Ronald Jackson II | Internal Medicine | 2301 Erwin Rd, Durham, NC 27710-0001 | 2008-05-14 |
| 1912928441 | Larry D Jackson | Personal Emergency Response Attendant | 500 Gypsy Ln, Youngstown, OH 44504-1315 | 2006-07-21 |
| 1275574295 | Larry K Jackson | Internal Medicine | 2660 10th Ave S, Suite 528, Birmingham, AL 35205-1605 | 2006-06-09 |
| 1720049349 | Larry Jackson | Family Medicine | 6565 W Main St, Kalamazoo, MI 49009-6114 | 2006-03-31 |
| Street Address |
1445 GATEWAY BLVD |
| City | COTTAGE GROVE |
| State | OR |
| Zip Code | 97424-1224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093714701 | Nancy J Worley | Physical Medicine & Rehabilitation | 1445 Gateway Blvd, Suite D, Cottage Grove, OR 97424 | 2005-07-15 |
| 1255683140 | Martin Roco | Nurse Practitioner | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2012-10-03 |
| 1891070207 | Devon E. Schneider | Nurse Practitioner | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2011-10-17 |
| 1609068998 | Covered Bridge Physical Therapy LLC | Clinic/Center | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2007-08-10 |
| 1720152465 | Ben Douglas Johnson | Physician Assistant | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2006-11-17 |
| 1932281656 | William Vogel | Physician Assistant | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2006-10-20 |
| 1750492906 | Icco LLC | Clinic/Center | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2006-08-31 |
| 1407872815 | Diana L. V. Knee | Social Worker | 1445 Gateway Blvd, Suite A, Cottage Grove, OR 97424-1224 | 2006-07-15 |
| 1326085846 | Mary Ruth | Nurse Practitioner | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2006-06-01 |
| 1225001720 | Judith Dolene Stensland | Family Medicine | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2006-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851936157 | Naomi Higgs | Physical Therapy Assistant | 515 Grant St, Cottage Grove, OR 97424 | 2019-11-10 |
| 1588131296 | Home Town Drugs of Cottage Grove, Inc. | Pharmacy | 1205 Hwy 99 North, Cottage Grove, OR 97424 | 2018-10-31 |
| 1215420625 | Zachary Booth | Student in an Organized Health Care Education/Training Program | 28188 Cottage Grove Lorane Rd, Cottage Grove, OR 97424 | 2018-06-11 |
| 1124404090 | Eileen Nittler | Social Worker | 1345 Birch Avenue, Cottage Grove, OR 97424 | 2015-08-03 |
| 1851799787 | Kathryn Brooks | Licensed Practical Nurse | 520 Patrick Loop, Cottage Grove, OR 97424 | 2014-12-09 |
| 1558767814 | Michele Renee Savage | Orthotic Fitter | 148 Gateway Blvd, Cottage Grove, OR 97424 | 2014-11-14 |
| 1730598558 | John Mansfield | Pharmacist | 120 Andrew Drive, Cottage Grove, OR 97424 | 2014-08-06 |
| 1700213493 | Aspen Injury Center LLC | Chiropractor | 1260 East Main Street, Cottage Grove, OR 97424 | 2013-09-26 |
| 1609172956 | Megan Olds | Counselor | 37 South 6th Street, Cottage Grove, OR 97424 | 2011-02-03 |
| 1144530726 | Monica G Radley | Counselor | 1345 Birch Ave., Cottage Grove, OR 97424 | 2010-10-15 |
| Find all providers in zip 97424 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255770962 | Southside At The Cottage Grove Site | Family Medicine | 8454 East Point Douglas Road, Cottage Grove, MN 55016 | 2013-06-17 |
| 1821363227 | James Michael Tandrow | Family Medicine | 205 Buttercup Loop, Cottage Grove, OR 97424-2069 | 2012-03-19 |
| 1922322619 | Sheryl Spitzer -resnick Md, LLC | Family Medicine | 251 East Cottage Grove Road, Cottage Grove, WI 53527 | 2010-03-24 |
| 1821277716 | Shaswita Chintalpuri | Family Medicine | 7500 80th Street South, Suite 100 - Mail Stop 34624a, Healthpartners Cottage Grove Clinic, Cottage Grove, MN 55016-3008 | 2007-10-29 |
| 1912120114 | Mary E Gabriele | Family Medicine | 502 E Whiteaker Ave, Cottage Grove, OR 97424-1648 | 2007-04-10 |
| 1386769735 | Joseph R.f. Kalugdan | Family Medicine | 7500 80th St S Ste 100, Healthpartners Cottage Grove Clinic, Cottage Grove, MN 55016-3008 | 2007-03-21 |
| 1275663247 | Paul A Bilder | Family Medicine | 1445 Gateway Blvd., Cottage Grove, OR 97424 | 2007-03-07 |
| 1225115124 | Wildwood Family Clinic, Sc | Family Medicine | 535 Southing Grange, Cottage Grove, WI 53527-9338 | 2006-11-01 |
| 1487748943 | Katrina Carol Groves-rehwaldt | Family Medicine | 1515 Village Dr Ste 200, Cottage Grove, OR 97424 | 2006-10-02 |
| 1215980792 | Martha J Masciopinto | Family Medicine | 10010 Kimbro Ave S, Cottage Grove, MN 55016-4151 | 2006-05-18 |
| Find all providers in COTTAGE GROVE | ||||
| City | COTTAGE GROVE |
| Zip Code | 97424 |
Please comment or provide details below to improve the information on MR. LARRY ARTHUR JACKSON.
| 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.