KATHY JACKSON (NPI# 1790175354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790175354 |
| Entity Type | Individual |
| Full Name | KATHY JACKSON |
| Practice Address |
850 W Ironwood Dr Ste 302 Coeur D Alene ID 83814-4903 |
| Practice Telephone | 2086645225 |
| Practice Fax Number | 2086645228 |
| Mailing Telephone | 2086645225 |
| Mailing Fax Number | 2086645228 |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MASG2105 | ID | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255940391 | Kathy Lorine Jackson | Technician | 2504 Toms Creek Rd, Wayne, WV 25570-9458 | 2020-07-24 |
| 1861835860 | Kathy Melton Jackson | Registered Nurse | 6051 Wescott Rd, Columbia, SC 29212-1408 | 2013-04-10 |
| 1619283595 | Kathy L Jackson | Private Vehicle | 15685 N Iron Bridge Rd, Marshall, IL 62441-4663 | 2010-08-30 |
| 1215971379 | Kathy M Jackson | Family Medicine | 502 W Central Ave, La Follette, TN 37766-3400 | 2006-06-16 |
| 1740795285 | Kathy Joy Jackson | Social Worker | 11401 Lorain Ave, Cleveland, OH 44111-5428 | 2017-12-06 |
| 1154728319 | Kathy Lacole Jackson | Public Health or Welfare | 151 E Wood St, Spartanburg, SC 29303-3016 | 2014-12-03 |
| 1255689337 | Kathy Lynn Jackson | Counselor | 7611 Saint Vincent Ave, Shreveport, LA 71106-4231 | 2012-08-21 |
| 1104088749 | Kathy Jackson | Physical Therapist | 714 W Grove St, El Dorado, AR 71730-4416 | 2008-06-25 |
| 1306914296 | Kathy Jo Jackson | Pediatrics | 117 W Paterson St, Kalamazoo, MI 49007-2557 | 2006-12-01 |
| 1811060379 | Kathy Jackson | Physical Therapist | 10820 Marvin E. Jones Blvd., Live Oak, FL 32060 | 2006-11-15 |
| Street Address |
850 W IRONWOOD DR STE 302 |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-4903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457906463 | Shelly Ann Zolezzi | Massage Therapist | 850 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814-4903 | 2019-08-06 |
| 1720546542 | Levi Dumont | Massage Therapist | 850 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814-4903 | 2019-03-11 |
| 1033631387 | Tammy Marie Mac | Massage Therapist | 850 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814-4903 | 2017-07-07 |
| 1083060032 | Veronica Guadalupe Reyes | Massage Therapist | 850 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814-4903 | 2016-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912517525 | Heidi Burk | Massage Therapist | 206 E Indiana Ave Ste 116, Coeur D Alene, ID 83814-2969 | 2020-08-07 |
| 1346808276 | Carynne Bailey | Massage Therapist | 2005 Ironwood Pkwy Ste 220, Coeur D Alene, ID 83814-2647 | 2019-06-05 |
| 1568020451 | Misty C Keeler | Massage Therapist | 4061 Idewild Loop Unit 306, Coeur D Alene, ID 83814-7094 | 2019-06-05 |
| 1538624283 | Sarah Judge | Massage Therapist | 1104 N 4th St Ste B, Coeur D Alene, ID 83814-3217 | 2019-02-06 |
| 1336617372 | Coeur D Alene Massage School LLC | Massage Therapist | 1625 N 4th St Ste 203, Coeur D Alene, ID 83814-6178 | 2018-11-07 |
| 1023516440 | Chelsea Stillman | Massage Therapist | 3157 N Fruitland Ln, Coeur D Alene, ID 83815-8165 | 2018-01-31 |
| 1487166872 | Erika Jean Beachler | Massage Therapist | 1103 E Best Ave Ste D, Coeur D Alene, ID 83814-4878 | 2017-10-25 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| 1386178390 | Briana Crotinger | Massage Therapist | 520 E Coeur Dalene Ave Rm 2, Coeur D Alene, ID 83814-2873 | 2017-04-17 |
| 1821539776 | Amanda Michele Pankratz | Massage Therapist | 708 N 20th St, Coeur D Alene, ID 83814-5506 | 2017-03-12 |
| Find all providers in COEUR D ALENE | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
Please comment or provide details below to improve the information on KATHY JACKSON.
| 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.