DR. RODNEY MARK JACKSON (NPI# 1619975398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619975398 |
| Entity Type | Individual |
| Full Name | DR. RODNEY MARK JACKSON |
| Credential | MD,FAAP |
| Practice Address |
3654 W Anthem Way Suite B-114 Anthem AZ 85086-0455 |
| Practice Telephone | 6235510442 |
| Practice Fax Number | 6235517389 |
| Mailing Telephone | 6235510442 |
| Mailing Fax Number | 6235517389 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 28940 | AZ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 576077 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063972669 | Rodney Lajuan Jackson Jr. | Behavior Technician | 7445 39th Pl N, St Petersburg, FL 33709-4310 | 2019-03-21 |
| 1205125747 | Rodney Jackson | Occupational Therapist | 18135 W Catawba Ave Ste 11, Cornelius, NC 28031-5641 | 2011-04-05 |
| 1306981295 | Rodney Jackson | Case Manager/Care Coordinator | 5849 Crocker St Unit L, Los Angeles, CA 90003-1311 | 2007-02-20 |
| 1205931599 | Rodney Allen Jackson | Dentist | 2517 Sir Barton Way Ste 200, Lexington, KY 40509-2275 | 2006-09-13 |
| 1285659615 | Rodney Gilkey Jackson | Chiropractor | 309 Laurel Ave, Tillamook, OR 97141-2313 | 2006-07-13 |
| 1457838062 | Rodney Jackson Jr. | Case Manager/Care Coordinator | 1800 Mercy Dr, Orlando, FL 32808-5646 | 2018-07-26 |
| 1538602941 | Rodney Jackson Sr. | Nurse's Aide | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2016-12-02 |
| 1093965089 | Rodney Dewayne Jackson | Specialist | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2008-09-25 |
| Street Address |
3654 W ANTHEM WAY SUITE B-114 |
| City | ANTHEM |
| State | AZ |
| Zip Code | 85086-0455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891790119 | Michael D Beebe | Physical Therapist | 3654 W Anthem Way, Ste B102, Anthem, AZ 85086-0455 | 2005-06-14 |
| 1891120762 | Wendy Lynn Borgersen | Nurse Practitioner | 3654 W Anthem Way, Suite B-114, Anthem, AZ 85086-0455 | 2013-09-10 |
| 1275838658 | Charlynn Darrah | Physical Therapist | 3654 W Anthem Way, Suite B102, Anthem, AZ 85086-0455 | 2011-01-17 |
| 1952441008 | Daisy Mountain Surgical Associates Pllc | Surgery | 3654 W Anthem Way, Suite B102, Anthem, AZ 85086-0455 | 2007-02-07 |
| 1871639476 | Nicole Besana | Physical Therapist | 3654 W Anthem Way, Suite B102, Anthem, AZ 85086-0455 | 2007-01-30 |
| 1760594543 | David Sung-yen Yip | Pediatrics | 3654 W Anthem Way, Suite B-114, Anthem, AZ 85086-0455 | 2006-08-31 |
| 1972508208 | Aaron H Williams | Physical Therapist | 3654 W Anthem Way, Ste B102, Anthem, AZ 85086-0455 | 2005-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097703 | Cindy Ryanto | Pharmacist | 39508 W Daisy Mountain Dr, Phoenix, AZ 85086 | 2020-09-15 |
| 1912559857 | Cathey Michelle Allen | Massage Therapist | 39006 N 11th Ave, Phoenix, AZ 85086 | 2019-07-11 |
| 1174000871 | Anthem Eye Group Pllc | Optometrist | 4205 W Anthem Way #101, Anthem, AZ 85086 | 2018-07-25 |
| 1366982449 | Angela Ann Childs | Registered Nurse | 42104 N Venture Dr Ste D118, Anthem, AZ 85086 | 2017-03-08 |
| 1144772054 | Joe Bezerra | Specialist | 39818 N Bell Meadow Trl, Phoenix, AZ 85086 | 2016-10-26 |
| 1669821252 | Arizona Procedural Center | Clinic/Center | 3655 West Anthem Way, Suite 109 Box 272, Athem, AZ 85086 | 2016-06-06 |
| 1124499280 | Shane Carr | Physical Therapist | 39716 N 7th St, Phoenix, AZ 85086 | 2015-10-15 |
| 1790174167 | Kelly Christine Collins | Dermatology | 42211 N 41st Dr. #a109, Phoenix, AZ 85086 | 2015-01-22 |
| 1174953913 | Sung Ae Lee | Radiology | 820 W. Ravina Lane, Anthem, AZ 85086 | 2013-11-14 |
| 1881034080 | Bryan Michael Hays | Dentist | 40411 N Capra Way, Anthem, AZ 85086 | 2013-07-02 |
| Find all providers in zip 85086 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477730554 | Pain Medicine Specialists PC | Specialist | 3654 Wanthem Blvd, Ste B106, Anthem, AZ 85086-0455 | 2008-01-30 |
| 1699118943 | Sean Michael Ormond | Specialist | 3618 W Anthem Way Ste D120, Anthem, AZ 85086-0458 | 2013-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942810833 | Modern Sports Medicine LLC | Specialist | 6242 E Arbor Ave Unit 1, Mesa, AZ 85206-1309 | 2020-08-05 |
| 1518576123 | Multi Specialty Physicians Group Inc | Specialist | 8428 E Shea Blvd Ste 101, Scottsdale, AZ 85260-6663 | 2020-07-29 |
| 1902420698 | Doug S Clouse Md Plc | Specialist | 3636 N Stockton Hill Rd Ste 3, Kingman, AZ 86409-0514 | 2020-05-29 |
| 1518580869 | Zegarra Hospital and Nursing Home Services Pllc | Specialist | 2182 Hway 95, Bullhead City, AZ 86442-6044 | 2020-05-21 |
| 1154942829 | Fresh Start Bone and Joint Institue | Specialist | 485 S Watson Rd Ste 103-438, Buckeye, AZ 85326-3452 | 2020-05-04 |
| 1902462179 | Physician Group of Arizona Inc | Specialist | 4801 E Washington St Ste 200, Phoenix, AZ 85034-2019 | 2019-05-14 |
| 1447814751 | Carmen Tasse | Specialist | 3260 N Hayden Rd Ste 110, Scottsdale, AZ 85251-6650 | 2019-04-23 |
| 1790246924 | Mark A Meyers | Specialist | 715 S Beeline Hwy Ste A, Payson, AZ 85541-5344 | 2019-03-29 |
| 1386113538 | Wound Care Associates LLC | Specialist | 2600 E Southern Ave Ste F2, Tempe, AZ 85282-7626 | 2018-11-16 |
| 1366920910 | Haleys Designer Wigs | Specialist | 6017 E Mckellips Rd Ste 109, Mesa, AZ 85215-2824 | 2018-08-04 |
| Find all providers with the same taxonomy | ||||
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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.