KELLY JACKSON (NPI# 1619457926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619457926 |
| Entity Type | Individual |
| Full Name | KELLY JACKSON |
| Credential | PA-C |
| Practice Address |
12300 Mccracken Rd Garfield Heights OH 44125-2975 |
| Mailing Address |
884 Maple Shade Rd Cranberry PA 16319-3318 |
| Practice Telephone | 4125120798 |
| Mailing Telephone | 4125120798 |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588036263 | Kelly Jackson | Social Worker | 2937 Ne 16th Ter, Gainesville, FL 32609-3234 | 2015-10-21 |
| 1477896876 | Kelly A Jackson | Occupational Therapist | 178 Manila Ave, Staten Island, NY 10306-5608 | 2013-04-03 |
| 1104986793 | Kelly A Jackson | Chiropractor | 190 North Main Street, Natick, MA 01760 | 2006-12-12 |
| 1518982487 | Kelly Donald Jackson | Dentist | 3023 Eastland Blvd Ste 112, Clearwater, FL 33761-4106 | 2006-07-13 |
| 1689273310 | Kelly Jackson | Behavior Technician | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5312 | 2020-10-23 |
| 1629544655 | Kelly Colleen Jackson | Counselor | 811 Madison St, Everett, WA 98203-4543 | 2018-10-17 |
| 1760961833 | Kelly D Jackson | Licensed Practical Nurse | 602 W Semands St, Conroe, TX 77301-1867 | 2018-08-09 |
| 1841780178 | Kelly Amanda Jackson | Nurse Practitioner | 1700 Medical Center Pkwy, Murfreesboro, TN 37129-2245 | 2018-05-11 |
| 1033653431 | Kelly Jackson | Nurse Practitioner | 606 W Columbia St, San Augustine, TX 75972-1709 | 2016-12-05 |
| 1497108310 | Kelly Jackson | Massage Therapist | 1325 San Marco Blvd, Suite 102, Jacksonville, FL 32207-8568 | 2016-07-15 |
| Street Address |
12300 MCCRACKEN RD |
| City | GARFIELD HEIGHTS |
| State | OH |
| Zip Code | 44125-2975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366070096 | Kathleen Myers | Occupational Therapist | 12300 Mccracken Rd, Garfield Heights, OH 44125-2975 | 2020-03-30 |
| 1316575343 | Marylou Yaskanich | Occupational Therapist | 12300 Mccracken Rd, Garfield Heights, OH 44125-2975 | 2020-03-27 |
| 1558908400 | Lydia Lee Potoma | Psychiatry & Neurology | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2019-12-10 |
| 1659842805 | Laura Emily Umek | Physician Assistant | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2018-12-16 |
| 1780103945 | Irena Priadoun | Dietitian, Registered | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2017-09-19 |
| 1366984387 | Nicole Mccorkindale | Pharmacist | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2016-11-08 |
| 1790138089 | Joseph Williams | Pharmacist | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2016-07-21 |
| 1366891327 | Thomas Fowler | Emergency Medicine | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2016-06-09 |
| 1205297678 | Tatyana Kligman | Nurse Practitioner | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2016-03-14 |
| 1770943912 | Darleen Myers | Nurse Practitioner | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2016-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245852268 | Rosemary B. Field | Registered Nurse | 12500 Mccracken Rd, Garfield Heights, OH 44125 | 2020-05-13 |
| 1720639040 | Unique Jones | Technician | 8137 Reed Ave, Garfield Hts, OH 44125 | 2019-09-27 |
| 1215404736 | Lauren Deniese Taylor | Nurse Practitioner | Marymount Hospital, 12300 Mccracken Road, Garfield Heights, OH 44125 | 2018-11-02 |
| 1023599925 | Fresenius Medical Care Garfield Heights Home, LLC | Clinic/Center | 9729 Granger Rd, Garfield Heights, OH 44125 | 2018-08-28 |
| 1306326939 | John Paul Allison | Nurse Practitioner | 12300 Mckraken Road, Garfield Heights, OH 44125 | 2018-08-14 |
| 1629573944 | Chelsee Christine Williams | Case Manager/Care Coordinator | 12395 Mccraken Rd Suite A, Garfield Heights, OH 44125 | 2018-03-28 |
| 1730605908 | Shauntae Patterson | Home Health | 8133 Garfield Blvd Upstairs, Garfield Heights, OH 44125 | 2017-08-18 |
| 1134643398 | Velma Charis George | Licensed Practical Nurse | 11414 Mccracken Road, Garfield Hts, OH 44125 | 2017-07-31 |
| 1528591450 | Joanne Biltz Biltz | Speech-Language Pathologist | 12801 Bangor, Garfield Heights, OH 44125 | 2017-04-07 |
| 1235670340 | Mike Johanek | Pharmacist | 8333 Rockside Road, Valley View, OH 44125 | 2017-03-09 |
| Find all providers in zip 44125 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336795822 | Sindhu Kurup | Physician Assistant | 12395 Mccracken Rd, Garfield Heights, OH 44125-2967 | 2019-08-12 |
| 1366907891 | Yelena Levandovski | Physician Assistant | 12395 Mccracken Rd Ste A, Garfield Heights, OH 44125-2946 | 2019-02-08 |
| 1659842805 | Laura Emily Umek | Physician Assistant | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2018-12-16 |
| 1891153409 | Aubrey Dawn Winkler-krueger | Physician Assistant | 12395 Mccracken Rd, Suite A-up, Garfield Heights, OH 44125-2967 | 2016-02-10 |
| 1619004595 | Todd J Harris | Physician Assistant | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2007-02-27 |
| 1669435939 | Kenneth George | Physician Assistant | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2006-04-08 |
| 1275595951 | Judy Glesius | Physician Assistant | 12300 Mccracken Rd, Garfield Heights, OH 44125-2914 | 2006-04-06 |
| 1255320917 | Barbara L Pritchard | Physician Assistant | 12000 Mccracken Rd, #357, Garfield Heights, OH 44125-2964 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750221 | Kathryn Eileen Aurand | Physician Assistant | 1020 E 346th St, Eastlake, OH 44095-2629 | 2020-11-06 |
| 1508467010 | Amanda Dawn Smith | Physician Assistant | 1621 Spruce St, Zanesville, OH 43701-2534 | 2020-11-03 |
| 1356941603 | Ingrid Mompoint-butler | Physician Assistant | 1911 Oakland Park Ave, Columbus, OH 43224-3630 | 2020-10-27 |
| 1083213946 | Breanne Lyon | Physician Assistant | 870 S Troy Ave, Cincinnati, OH 45246-4620 | 2020-10-21 |
| 1669071908 | Hannah Murrin | Physician Assistant | 4329 Marival Way, Mason, OH 45040-2867 | 2020-10-19 |
| 1861091241 | Beau Webb | Physician Assistant | 6017 Cruxten Dr, Dayton, OH 45424-3702 | 2020-10-18 |
| 1467051821 | Kelsey Nicole Weiss | Physician Assistant | 9025 Peacock Way Unit 206, West Chester, OH 45069-1659 | 2020-10-18 |
| 1215535489 | Caitlin Cahill | Physician Assistant | 2470 Merrybell Ct, Grove City, OH 43123-8724 | 2020-10-11 |
| 1174121461 | Thuy Lam Pham | Physician Assistant | 505 Brodywood Dr, Toledo, OH 43615-4589 | 2020-10-09 |
| 1508463506 | John Ronald Creighton | Physician Assistant | 7460 Marion St Apt B, Chesterhill, OH 43728-9613 | 2020-10-03 |
| Find all providers with the same taxonomy | ||||
| City | GARFIELD HEIGHTS |
| Zip Code | 44125 |
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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.