GARY L JACKSON (NPI# 1700884947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700884947 |
| Entity Type | Individual |
| Full Name | GARY L JACKSON |
| Credential | CRNA |
| Practice Address |
4100 Summerhill Rd Texarkana TX 75503-2732 |
| Practice Telephone | 9037359802 |
| Practice Fax Number | 9037359806 |
| Mailing Telephone | 9037359802 |
| Mailing Fax Number | 9037359806 |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2014-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 231425 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS | 83137C | 01 |
| AR | BLUE CROSS | 84320 | 01 |
| TX | 002851601 | 05 | |
| AR | 117307701 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033462932 | Gary D Jackson | Counselor | 4610 Santa Anita Blvd, Suite D, El Monte, CA 91731 | 2012-10-17 |
| 1720317688 | Gary Howard Jackson | Orthopaedic Surgery | 38 Bent Pebble Pt, Lumberton, MS 39455-9037 | 2009-12-23 |
| 1578692331 | Gary L. Jackson | Internal Medicine | Lincoln County Medical Center, 211 Sudderth, Ruidoso, NM 88345 | 2007-03-05 |
| 1447237839 | Gary Lee Jackson | Chiropractor | 20595 Sw Tv Hwy #102, Ste 102, Aloha, OR 97006 | 2005-12-27 |
| 1609426022 | Gary Dean Jackson | Pharmacist | 11340 Three Rivers Rd Ste A, Gulfport, MS 39503-3650 | 2019-09-17 |
| 1992119838 | Gary Chase Jackson | Optometrist | 6030 W University Blvd, Odessa, TX 79764 | 2014-06-18 |
| 1154528263 | Gary Wayne Jackson | Physician Assistant | 1804 College Ave, Levelland, TX 79336-6507 | 2007-07-02 |
| 1447473772 | Gary Jackson | Counselor | 1756 S Lewis Rd, Camarillo, CA 93012-8520 | 2007-04-11 |
| Street Address |
4100 SUMMERHILL RD |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503-2732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245238740 | David R Weber | Anesthesiology | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2005-07-08 |
| 1508472655 | Samaritan Integrative Services, LLC | Clinic/Center | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2020-09-23 |
| 1790101384 | Anesthesiology Associates of Texarkana Pa | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2014-03-06 |
| 1255678298 | Justin G. Fitts | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2013-01-10 |
| 1003107749 | Brandon Wiley | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2011-04-28 |
| 1710281092 | Amy Danielle Lawing | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2010-12-31 |
| 1144531187 | Paul Mitchell James | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2010-06-24 |
| 1518286541 | Andrew Dixon Fuller | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2010-06-01 |
| 1619209384 | David Galyon | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2010-02-05 |
| 1952632911 | Jake Sawyer | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2010-01-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477164440 | Royal Anesthesia Inc. | Nurse Anesthetist, Certified Registered | 1802 Moores Ln Ste 200, Texarkana, TX 75503-4609 | 2020-08-13 |
| 1467009621 | Texarkana Sedation LLC | Nurse Anesthetist, Certified Registered | 1902 Moores Ln Ste B, Texarkana, TX 75503-4668 | 2019-08-22 |
| 1104363258 | Brent Willis | Nurse Anesthetist, Certified Registered | 203 La Grange Dr., Texarkana, TX 75501 | 2017-01-27 |
| 1720101934 | Office Anesthesia Service LLC | Nurse Anesthetist, Certified Registered | 1730 Galleria Oaks Dr, Texarkana, TX 75503-4649 | 2007-04-10 |
| 1861483547 | Cesar Jonathan Baylon | Nurse Anesthetist, Certified Registered | 3211 Sugar Hilrd L, Texarkana, AR 71854 | 2005-11-02 |
| 1740288638 | David F Sellers | Nurse Anesthetist, Certified Registered | 4080 Summerhill Sq, Texarkana, TX 75503-2730 | 2005-07-13 |
| 1588662837 | Per I Eiane | Nurse Anesthetist, Certified Registered | 4500 Summerhill Rd, Texarkana, TX 75503-2740 | 2005-07-11 |
| 1689182438 | Lab Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 1902 Moores Ln, Texarkana, TX 75503-4610 | 2018-01-15 |
| 1790101384 | Anesthesiology Associates of Texarkana Pa | Nurse Anesthetist, Certified Registered | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2014-03-06 |
| 1700211737 | Twice Nice Anesthesia Associates, Pllc | Nurse Anesthetist, Certified Registered | 1000 Pine St, Texarkana, TX 75501-5100 | 2013-09-10 |
| Find all providers in TEXARKANA | ||||
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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.