MR. CLINTON O JACKSON (NPI# 1659675361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659675361 |
| Entity Type | Individual |
| Full Name | MR. CLINTON O JACKSON |
| Practice Address |
12244 Breckenridge Dr Eagle River AK 99577-7656 |
| Mailing Address |
Po Box 671288 Chugiak AK 99567-1288 |
| Practice Telephone | 9076946161 |
| Mailing Telephone | 9076946161 |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2019-07-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 237700000X | Hearing Instrument Specialist | 1090102 | AK | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346416955 | Clinton Wayne Jackson Jr. | Social Worker | 2400 Hospital Rd, Tuskegee, AL 36083-5001 | 2008-05-03 |
| Street Address |
12244 BRECKENRIDGE DR |
| City | EAGLE RIVER |
| State | AK |
| Zip Code | 99577-7656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831758333 | Dianne E Lyons | Behavior Technician | 16331 Heritage Place, Suite 101, Eagle River, AK 99577 | 2019-06-07 |
| 1073007209 | Center for Natural Medicine, Inc. | Acupuncturist | 16844 Easy St, Eagle River, AK 99577 | 2018-06-20 |
| 1538652748 | Shelly Rana Budde | Nurse Practitioner | 19139 Upper Skyline Dr, Eagle River, AK 99577 | 2018-06-12 |
| 1700387529 | Aaron Wesley Jones | Behavior Technician | 16941 Notrh Eagle River Loop Road, Eagle River, Ak, AK 99577 | 2018-02-27 |
| 1033641881 | Sierra Bracken | Massage Therapist | 12812 Old Glenn Hwy, Ste C3, Eagle River, AK 99577 | 2017-03-31 |
| 1699213231 | Jolene Denee Rogers | Counselor | 13620 Old Glenn Hwy, Ste C, Eagle River, AK 99577 | 2017-02-02 |
| 1881040962 | Elizabeth Hanson | Behavioral Analyst | 16941 North Eagle River Loop Road, Suite 3, Eagle River, AK 99577 | 2016-05-09 |
| 1023496148 | Joel Richard Wallace | Dentist | 16727 Farm Avenue, Eagle River, AK 99577 | 2015-05-08 |
| 1184019663 | Nicole Christine Newman | Physician Assistant | 11432 Business Blvd., Suite 4, Eagle River, AK 99577 | 2015-04-01 |
| 1417365362 | Tammi Smith | Community Health Worker | 16510 Centerfield Dr B 107, Eagle River, AK 99577 | 2014-07-23 |
| Find all providers in zip 99577 | ||||
| Taxonomy Code | 237700000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Hearing Instrument Specialist |
| Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184165896 | Eva Long | Hearing Instrument Specialist | 310 K St Ste 273, Anchorage, AK 99501-2064 | 2017-03-14 |
| 1639521628 | Advanced Affordable Hearing, LLC | Hearing Instrument Specialist | 310 K St Ste 278, Anchorage, AK 99501-2064 | 2016-07-01 |
| 1093167082 | Advanced Affordable Hearing, LLC | Hearing Instrument Specialist | 310 K St Ste 280, Anchorage, AK 99501-2064 | 2016-07-01 |
| 1578914453 | Advanced Affordable Hearing, LLC | Hearing Instrument Specialist | 310 K St Ste 276, Anchorage, AK 99501-2064 | 2016-06-22 |
| 1902256241 | Advanced Affordable Hearing, LLC | Hearing Instrument Specialist | 310 K St Ste 282, Anchorage, AK 99501-2064 | 2016-06-17 |
| 1568856615 | Advanced Affordable Hearing, LLC | Hearing Instrument Specialist | 310 K St Ste 284, Anchorage, AK 99501-2064 | 2015-03-26 |
| 1659786994 | Choice Providers, LLC | Hearing Instrument Specialist | 310 K St Ste 220, Anchorage, AK 99501-2064 | 2014-06-25 |
| 1518389204 | Kenneth Klepinger | Hearing Instrument Specialist | 9095 Glacier Hwy Ste 103, Juneau, AK 99801-6912 | 2014-01-14 |
| 1023352267 | Alaska Hearing Help Ctr Inc | Hearing Instrument Specialist | 1005 E Dimond Blvd, Ste 3, Anchorage, AK 99515-2050 | 2012-11-10 |
| 1235487513 | George Y Boyle | Hearing Instrument Specialist | 700 E Northern Lights Blvd, Anchorage, AK 99503-4133 | 2012-08-17 |
| Find all providers with the same taxonomy | ||||
| City | EAGLE RIVER |
| Zip Code | 99577 |
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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.