DR. ROBERT LEWIS JACKSON (NPI# 1720072200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720072200 |
| Entity Type | Individual |
| Full Name | DR. ROBERT LEWIS JACKSON |
| Credential | MD |
| Practice Address |
6286 Briarcrest Ave Suite 314 Memphis TN 38120-4078 |
| Practice Telephone | 9017617720 |
| Practice Fax Number | 9017615213 |
| Mailing Telephone | 9017617720 |
| Mailing Fax Number | 9017615213 |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 12016 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE SHIELD | J-85 | 01 |
| TN | 3-175279 | 05 | |
| AR | 114075001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701487 | Robert Jackson | Physical Therapist | 3056 Healthy Way Ste 116, Birmingham, AL 35243-2435 | 2019-10-11 |
| 1881003655 | Robert Donald Jackson | Social Worker | 151 Knollcroft Rd # 116d, Lyons, NJ 07939-5001 | 2014-08-06 |
| 1780005496 | Robert Earl Jackson Jr. | Community Health Worker | 17 Wickham Dr, Columbus, GA 31907-6328 | 2013-12-23 |
| 1073942371 | Robert Jackson | Massage Therapist | 502 11th St Se, Decatur, AL 35601-4908 | 2013-11-06 |
| 1447548573 | Robert Joseph Jackson | Licensed Practical Nurse | 5454 East State St, Hermitage, PA 16148 | 2011-07-11 |
| 1457515330 | Robert Anthony Jackson | Dentist | 2816 Veach Rd., Unit 305, Owensboro, KY 42303 | 2008-07-10 |
| 1437357399 | Robert D Jackson | Counselor | 5525 Erindale Dr Ste 112, Colorado Springs, CO 80918-6960 | 2007-07-03 |
| 1174736029 | Robert Allan Jackson | Physician Assistant | 2109 Brookview Ter Apt B, Pekin, IL 61554-7320 | 2007-05-08 |
| 1144389347 | Robert W Jackson | Dentist | 209 Mimosa Dr, Thomasville, GA 31792-6633 | 2006-12-06 |
| 1144305152 | Robert Eric Jackson | Internal Medicine | 291 Indian Lake Blvd, Hendersonville, TN 37075-3653 | 2006-10-26 |
| Street Address |
6286 BRIARCREST AVE SUITE 314 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38120-4078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748331 | Michael J Sorensen | Physical Medicine & Rehabilitation | 6286 Briarcrest Ave, Suite 200, Memphis, TN 38120-4023 | 2005-05-23 |
| 1518452861 | Catherine Nichole Taylor | Specialist/Technologist | 6286 Briarcrest Ave, Memphis, TN 38120-4023 | 2018-06-28 |
| 1770081788 | Mary Barrack Biddy | Physician Assistant | 6286 Briarcrest Ave, Memphis, TN 38120-4023 | 2018-01-24 |
| 1104364561 | Emily Colon | Physical Therapist | 6286 Briarcrest Ave, Suite 200, Memphis, TN 38120-4023 | 2017-02-06 |
| 1356886550 | Kevin Cody Tubbs | Physical Medicine & Rehabilitation | 6286 Briarcrest Ave, Memphis, TN 38120-4023 | 2016-12-23 |
| 1508214743 | Murphy Scott Wilson | Physical Therapist | 6286 Briarcrest Ave, Suite 110, Memphis, TN 38120 | 2016-05-27 |
| 1962894980 | David Smith Ll | Specialist/Technologist | 6286 Briarcrest Ave, Memphis, TN 38120-4023 | 2015-02-27 |
| 1942602974 | Ryan Francis Marx | Physical Therapist | 6286 Briarcrest Ave, Suite 110, Memphis, TN 38120-4023 | 2014-09-22 |
| 1285054312 | Christopher Z Wilkinson | Registered Nurse | 6286 Briarcrest Ave, Suite 200, Memphis, TN 38120-4023 | 2014-04-16 |
| 1205276557 | Nicholas Alan Cutter | Physical Therapist | 6286 Briarcrest Ave, Memphis, TN 38120-4023 | 2013-07-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285637 | Cobblestone Midwifery | Midwife | 5617 Ashley Square South, Memphis, TN 38120 | 2018-11-27 |
| 1649768870 | River City Neuropsychology, Pllc | Psychologist | 1661 International Dr., Suite 400, Memphis, TN 38120 | 2018-04-24 |
| 1841676152 | Jody Lavaun Clements | Dentist | 795 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2015-08-10 |
| 1578957122 | Christina Lumpkin | Nurse Practitioner | 6305 Humphreys Blvd Ste 101, Memphis, TN 38120 | 2015-03-21 |
| 1316352099 | Daniel Poor | Emergency Medicine | Baptist Memorial Hospital Memphis, 124 N. Humphrey's Blvd, Memphis, TN 38120 | 2014-06-21 |
| 1245643246 | Kysha Saleem | Nurse Practitioner | 6027 Walnut Grove Rd., Suite 312, Memphis, TN 38120 | 2014-06-06 |
| 1376962613 | John Christopher Swearingen | Dentist | 780 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2014-04-15 |
| 1275884645 | Rebecca Leigh Goedecke | Nurse Practitioner | 6215 Humphreys Blvd Ste 301, Memphis, TN 38120 | 2012-09-26 |
| 1730475179 | Sarah Elizabeth Hammond | Surgery | Plastic Surgery Group, 80 Humphreys Blvd #100, Memphis, TN 38120 | 2011-06-23 |
| 1922302785 | Daniel L Hester | Nurse Anesthetist, Certified Registered | 1755 Kirby Parkway Suite 330, Memphis, TN 38120 | 2011-01-07 |
| Find all providers in zip 38120 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013315373 | Robert J Kaplan, Md Pllc | Dermatology | 6401 Poplar Ave Ste 330, Memphis, TN 38119-4806 | 2014-12-18 |
| 1376892950 | Joshua W Cash | Dermatology | 6254 Poplar Ave, Memphis, TN 38119-4713 | 2012-08-29 |
| 1649493123 | Tejesh Patel | Dermatology | 930 Madison Ave Ste 801, Memphis, TN 38103-3410 | 2007-04-11 |
| 1114023611 | Alan Harris Tanenbaum | Dermatology | 760 E Brookhaven Cir, Memphis, TN 38117-4502 | 2006-09-15 |
| 1093817298 | Mark Harris Tanenbaum | Dermatology | 760 Brookhaven Circle, Memphis, TN 38117 | 2006-09-01 |
| 1831185677 | Charles Franklin Safley Jr. | Dermatology | 3814 Woodland Dr, Memphis, TN 38111 | 2005-09-27 |
| 1679937999 | Alexandra Dee Maxted Chantara | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2016-04-12 |
| 1619313756 | Whitney Gadd Shroyer | Dermatology | 910 Madison Ave Ste 1031, Memphis, TN 38103-3403 | 2013-05-15 |
| 1699119719 | Allison Vaughan Jones | Dermatology | 930 Madison Ave Ste 801, Memphis, TN 38163 | 2013-04-19 |
| 1376800979 | Joseph Pietrangelo | Dermatology | 1455 Union Ave, Memphis Dermatology Clinic, Memphis, TN 38104-6727 | 2012-04-19 |
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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.