JEAN LEIGH JACKSON (NPI# 1700840162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700840162 |
| Entity Type | Individual |
| Full Name | JEAN LEIGH JACKSON |
| Credential | MD |
| Practice Address |
2014 Washington St Newton MA 02462 |
| Mailing Address |
26 Bittersweet Ln Weston MA 02493 |
| Practice Telephone | 6172436040 |
| Practice Fax Number | 6172436924 |
| Mailing Telephone | 7818938896 |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2008-01-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207PP0204X |
Emergency Medicine Specialization: Pediatric Emergency Medicine |
07406 | RI | Allopathic & Osteopathic Physicians |
| Y | 207PP0204X |
Emergency Medicine Specialization: Pediatric Emergency Medicine |
212899 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TUFTS | 212899 | 01 | |
| MA | 3204821 | 05 | |
| BLUE SHIELD | J25711 | 01 | |
| HP | 5480 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346766870 | Jean Ann Jackson | Dietitian, Registered | 401 North Hooper Street, Caro, MI 48723 | 2017-08-16 |
| 1710048830 | Jean Petrilla Jackson | Counselor | 855 Central Dr, Odessa, TX 79761-4200 | 2006-12-12 |
| Street Address |
2014 WASHINGTON ST |
| City | NEWTON |
| State | MA |
| Zip Code | 02462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205818721 | Judy Z Yang | Internal Medicine | 2014 Washington St, Newton, MA 02462-1607 | 2005-11-18 |
| 1952916611 | Deanna Elizabeth Fiore | Nurse Practitioner | 2014 Washington St, Newton, MA 02462-1699 | 2020-09-10 |
| 1730799040 | Enoch Anyanwu | Registered Nurse | 2014 Washington St, Newton, MA 02462-1607 | 2020-08-03 |
| 1821627399 | Saghar Bagheri | Internal Medicine | 2014 Washington St, Newton, MA 02462-1699 | 2020-04-06 |
| 1356970206 | Alexandra Beling | Internal Medicine | 2014 Washington St, Newton, MA 02462-1699 | 2020-04-03 |
| 1790314656 | Micaela Rose Nannery | Internal Medicine | 2014 Washington St, Newton, MA 02462-1699 | 2020-04-03 |
| 1689202038 | Susruthi Rajanala | Internal Medicine | 2014 Washington St, Newton, MA 02462-1699 | 2020-03-31 |
| 1649808213 | Mary E. Awad | Internal Medicine | 2014 Washington St, Newton, MA 02462-1699 | 2020-03-30 |
| 1568090108 | Damir Ljuboja | Internal Medicine | 2014 Washington St, Newton, MA 02462-1699 | 2020-03-30 |
| 1417585076 | Steven Nicholas Baldassano | Internal Medicine | 2014 Washington St, Newton, MA 02462-1699 | 2020-03-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972151892 | Samuel Warren | Student in an Organized Health Care Education/Training Program | 2000 Washington St, Blue Building Suite 201, Newton, MA 02462 | 2019-09-04 |
| 1629486477 | Johanna Forman Lam | Nurse Practitioner | 2000 Washington St Ste 544, Newton, MA 02462 | 2014-07-24 |
| 1083909774 | Kristen A. Lindgren | Psychiatry & Neurology | Nwh Pediatric Ambulatory Care Center, 2014 Washington St, 6 South, Newton, MA 02462 | 2011-06-10 |
| 1346430436 | David Peselman | Pathology | Harvard Rehabilitation Clinic, Brockton, MA 02462 | 2007-07-26 |
| 1487776001 | Aaron Gardiner | Orthopaedic Surgery | 2000 Washington St #341, Newton Wellesley Orthopedic Associates, Inc., Newton, MA 02462 | 2007-04-04 |
| 1023194263 | Mark S Golden | Social Worker | 671 Grove St, Newton, MA 02462 | 2006-10-31 |
| 1477669331 | Elizabeth A Konig | Obstetrics & Gynecology | Newton Wellesley Ob/gyn, 2000 Washington Street, Newton, MA 02462 | 2006-08-22 |
| 1558477315 | Barry J Tils | Emergency Medicine | Newton Wellesly Hospital, 2014 Washington Street, Newton, MA 02462 | 2006-08-22 |
| 1134130040 | Aryeh Shestopal | Psychologist | 39 Clearwater Roard, Newton, MA 02462 | 2006-08-10 |
| 1861403347 | Nancy B Hurwitz | Physician Assistant | Newton Wellesley Hospital, 2014 Washington St, Newton, MA 02462 | 2006-08-10 |
| Find all providers in zip 02462 | ||||
| Taxonomy Code | 207PP0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Pediatric Emergency Medicine |
| Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/ Board certification is provided by the American Board of Emergency Medicine. Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104887678 | Jill Zimmer Simon | Emergency Medicine | 2014 Washington St, Newton, MA 02462 | 2006-03-31 |
| 1124088745 | Mary Christine Bailey | Emergency Medicine | 2014 Washington Street, Newton, MA 02462 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912223470 | Anthony Brian Kitchen | Emergency Medicine | 759 Chestnut St, Springfield, MA 01199-1619 | 2010-04-08 |
| 1104065531 | Cyril Sahyoun | Emergency Medicine | 300 Longwood Ave, Boston, MA 02115-5724 | 2009-02-09 |
| 1184861221 | Jennifer Jachowski | Emergency Medicine | 759 Chestnut St, Springfield, MA 01199-1619 | 2009-01-12 |
| 1093979403 | Jocelyn R Jensen | Emergency Medicine | 759 Chestnut St, Springfield, MA 01199-1619 | 2008-07-15 |
| 1275791931 | Raina Mitelia Paul | Emergency Medicine | 300 Longwood Ave, Department of Medicine-housestaff Lounge, Boston, MA 02115-5724 | 2008-05-29 |
| 1407030331 | Elizabeth Ann Coray | Emergency Medicine | 57 Highland Ave, Salem, MA 01970 | 2007-12-27 |
| 1578619250 | Lindsey Christine Burghardt | Emergency Medicine | 340 Wood Rd, Suite 310, Braintree, MA 02184-2401 | 2007-01-26 |
| 1609884519 | Ian James Thornley | Emergency Medicine | 57 Highland Ave, North Shore Childrens Hospital Pediatric Emergency Room, Salem, MA 01970 | 2006-08-04 |
| 1083658686 | Paul Kotzampaltiris | Emergency Medicine | 115 Lincoln Street, Metrowest Medical Center, Framingham, MA 01702 | 2006-06-15 |
| 1639118722 | Joeli Hettler | Emergency Medicine | 759 Chestnut Street, Springfield, MA 01199-1619 | 2006-06-05 |
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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.