CALVIN R JACKSON (NPI# 1740398338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740398338 |
| Entity Type | Individual |
| Full Name | CALVIN R JACKSON |
| Practice Address |
2123 Wrightsboro Rd Augusta GA 30904-4777 |
| Practice Telephone | 7067365244 |
| Practice Fax Number | 7067365246 |
| Mailing Telephone | 7067365244 |
| Mailing Fax Number | 7067365246 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2008-03-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 16449 | SC | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 031265 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 164495 | 05 | |
| GA | 000623796B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053701003 | Calvin Jackson | Massage Therapist | 101 E Main St, Ste 201, Monroe, WA 98272-1519 | 2015-01-29 |
| 1649226549 | Calvin Jackson | Counselor | 1311 N Dixie Hwy, Elizabethtown, KY 42701-2621 | 2006-05-25 |
| Street Address |
2123 WRIGHTSBORO RD |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-4777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164530689 | Csra Medical Associates | Internal Medicine | 2123 Wrightsboro Rd, Augusta, GA 30904-4777 | 2006-08-25 |
| 1578039798 | Blondenia Labrew | Nurse Practitioner | 2123 Wrightsboro Rd, Augusta, GA 30904-4777 | 2018-10-15 |
| 1679681183 | James Alvin Cato IIi | Single Specialty | 2123 Wrightsboro Rd, Augusta, GA 30904-4777 | 2006-08-25 |
| 1225146830 | Willie Mae Deas | Internal Medicine | 2123 Wrightsboro Rd, Augusta, GA 30904-4777 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598380842 | David Reynolds Cromer | Internal Medicine | 528 Walden Hills Ct, Augusta, GA 30909-0225 | 2020-06-12 |
| 1114542305 | Graham Skelton | Internal Medicine | 1480 Wrightsboro Rd Apt 6104, Augusta, GA 30901-3274 | 2020-06-12 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1467015628 | Adam Nikolas Davis | Internal Medicine | 1120 5th St, Augusta, GA 30912-0001 | 2019-04-15 |
| 1528621661 | Chadwick Scott Fitzgerald | Internal Medicine | 1459 Laney Walker Blvd Ste Ae3042, Augusta, GA 30912-0002 | 2019-04-15 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1326501560 | Awlad Hossain Bhuiyan | Internal Medicine | 120 15th St, Augusta, GA 30912-0001 | 2019-04-12 |
| 1033601315 | Mohammad Umair Azam | Internal Medicine | 1120 15th St # Bi5070, Augusta, GA 30912-0004 | 2018-06-03 |
| 1942732334 | Jennifer Espinal | Internal Medicine | 3651 Wheeler Rd Ofc, Augusta, GA 30909-6521 | 2017-04-03 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in AUGUSTA | ||||
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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.