DR. PETA-GAY JACKSON-BOOTH (NPI# 1760426902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760426902 |
| Entity Type | Individual |
| Full Name | DR. PETA-GAY JACKSON-BOOTH |
| Other Name | PETA-GAY JACKSON |
| Credential | M.D. |
| Practice Address |
2200 Kernan Drive Baltimore MD 21207 |
| Practice Telephone | 4104486283 |
| Practice Fax Number | 4104486277 |
| Mailing Telephone | 4104486283 |
| Mailing Fax Number | 4104486277 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2009-09-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | D0052122 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 110229896 | 05 |
| Street Address |
2200 KERNAN DRIVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255733929 | Randi Michelle Clary | Physical Therapist | 2200 Kernan Drive, Baltimore, MD 21207 | 2014-09-24 |
| 1356652721 | Clara Ellen Connor | Nurse Practitioner | 2200 Kernan Drive, James Lawrence Kernan Hospital, Baltimore, MD 21207 | 2010-06-30 |
| 1609192822 | Amy Bankard | Physical Therapist | 2200 Kernan Drive, Kernan Hospital, Baltimore, MD 21207 | 2010-04-13 |
| 1083840524 | Jacob Wynes | Podiatrist | 2200 Kernan Drive, Baltimore, MD 21207 | 2009-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821613373 | Keys Development Ta | Case Management | 7501 Liberty Rd Ste F/g, Keys Development Ta LLC., Gwynn Oak, MD 21207 | 2020-06-10 |
| 1891328431 | Day-by-day Healthcare LLC | Home Health Aide | 6817 Fox Meadow Rd, Gwynnoak, Baltimore, MD 21207 | 2020-02-21 |
| 1366005944 | Lacey Murphy | Social Worker | 6201 Liberty Road, Baltimore, MD 21207 | 2019-04-18 |
| 1811453368 | Pamela Powell | Social Worker | 5025 Dickey Hill Rd, Baltimore, MD 21207 | 2019-02-20 |
| 1568932176 | Reflections Counseling & Consulting | Community/Behavioral Health | 6901 Brightway, Unit F, Gwynn Oak, MD 21207 | 2018-11-27 |
| 1255849394 | Therapetic Wellness Services | Community/Behavioral Health | 4909 Liberty Heights Ave, Baltimore, MD 21207 | 2018-01-10 |
| 1922525252 | Passionate Hands Transitional Housing | Clinic/Center | 4711 Liberty Heights Avenue, Baltimore, MD 21207 | 2017-08-28 |
| 1528427689 | Stephen James Allen | Occupational Therapy Assistant | 4107 Liberty Heights Ave, Baltimore, MARYLAND 21207 | 2016-02-17 |
| 1255720439 | Dawn James | Counselor | 6401 Dogwood Road, Suite 201, Gwynn Oak, MD 21207 | 2015-01-12 |
| 1407251168 | Allcare International, Inc | Day Training, Developmentally Disabled Services | 3402 Milford Ave, Baltimore, MD 21207 | 2014-10-23 |
| Find all providers in zip 21207 | ||||
| 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 |
|---|---|---|---|---|
| 1184272296 | Federal Hill Pediatric Center | Internal Medicine | 724 Light St Ste A, Baltimore, MD 21230-3813 | 2019-09-02 |
| 1861051096 | Intermed Associates Ipa, LLC | Internal Medicine | 9106 Philadelphia Rd Ste 214, Baltimore, MD 21237-4333 | 2019-06-11 |
| 1720540925 | Johns Hopkins Community Physicians | Internal Medicine | 5210 Eastern Ave Ste 127, Baltimore, MD 21224-2719 | 2019-04-05 |
| 1013488188 | Atlantic Medical Associates, LLC | Internal Medicine | 6717 Park Heights Ave Lowr Level, Baltimore, MD 21215-2443 | 2018-12-16 |
| 1700386109 | Burke Medical, P.C. | Internal Medicine | 8 Market Pl Ste 300, Baltimore, MD 21202-4113 | 2018-02-13 |
| 1538695598 | Hisham Ahmed Farhan | Internal Medicine | 827 Linden Ave # B-2043, Baltimore, MD 21201-4606 | 2017-05-11 |
| 1538692652 | Thi Khuc | Internal Medicine | 22 S Greene St # N3w156, Baltimore, MD 21201-1544 | 2017-04-05 |
| 1053868646 | Apurva Sharma | Internal Medicine | 600 N Wolfe St Blalock 545, Baltimore, MD 21287-1766 | 2016-09-01 |
| 1053761031 | Seyed Mohammad Hodanazari | Internal Medicine | 727 W 40th St # A215, Baltimore, MD 21211-2105 | 2016-06-21 |
| 1568824522 | Alaina Christine Chodoff | Internal Medicine | 2024 E Monument St Fl 2, Baltimore, MD 21287-0028 | 2016-03-28 |
| Find all providers in BALTIMORE | ||||
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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.