MICHELLE LYNN JACKSON (NPI# 1790347722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790347722 |
| Entity Type | Individual |
| Full Name | MICHELLE LYNN JACKSON |
| Credential | APRN |
| Practice Address |
456 Circle Dr Kewanee IL 61443-3622 |
| Practice Telephone | 3095253256 |
| Mailing Telephone | 3095253256 |
| Enumeration Date | 2019-06-29 |
| Last Update Date | 2019-06-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 209.019281 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104434067 | Michelle Jackson | Behavior Technician | 6961 Rooks Ct Apt 305, Frederick, MD 21703-2781 | 2020-07-16 |
| 1396301487 | Michelle Jackson | Technician | 14000 Castle Blvd Apt 703, Silver Spring, MD 20904-4640 | 2019-05-14 |
| 1184196685 | Michelle Maria Jackson | Health Educator | 220 E 89th St, Brooklyn, NY 11236-1418 | 2018-12-20 |
| 1396253258 | Michelle Laray Jackson | Counselor | 3765 Carisbrook Dr, North Las Vegas, NV 89081-6631 | 2018-01-12 |
| 1427509173 | Michelle Jackson | Behavioral Analyst | 115 Franklin St Ne Apt H21, Washington, DC 20002-1091 | 2016-10-18 |
| 1891193678 | Michelle Jackson | Occupational Therapy Assistant | 12611 Hickman Pl, Denver, CO 80239-6204 | 2014-12-10 |
| 1215338330 | Michelle Jackson | Nurse Practitioner | 115 Fields St # De, Mooresville, IN 46158-1492 | 2014-09-08 |
| 1699058008 | Michelle A Jackson | Occupational Therapist | 6045 Ashford Ln, Unit 102, Naples, FL 34110-2416 | 2011-09-21 |
| 1285923185 | Michelle Ann Jackson | Rehabilitation Practitioner | 7124 Diving Petrels Pl, 7124 Diving Petrels Pl, North Las Vegas, NV 89084-2353 | 2011-03-31 |
| 1063650802 | Michelle Jackson | Occupational Therapy Assistant | 10200 Richmond Ave, Houston, TX 77042-4140 | 2009-02-02 |
| Street Address |
456 CIRCLE DR |
| City | KEWANEE |
| State | IL |
| Zip Code | 61443-3622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013453471 | Kelly Neirynck | Licensed Practical Nurse | 420 E Mill St, Kewanee, IL 61443 | 2017-01-10 |
| 1275760456 | Daniel P. Congreve | Surgery | 1051 West South Street, Kewanee, IL 61443 | 2009-06-16 |
| 1215188487 | Petersen Health Care, Inc | Nursing Facility/Intermediate Care Facility | 144 Jounior Ave., Kewanee, IL 61443 | 2008-10-07 |
| 1114112265 | Carla Greby | Internal Medicine | 2021 Kentville Rd, Iyc Kewanee, Kewanee, IL 61443 | 2007-09-12 |
| 1740362979 | Petersen Health Systems, Inc | Assisted Living Facility | 808 Sunset Drive, Kewanee, IL 61443 | 2006-10-19 |
| 1902993652 | Kerry Howard Head | Optometrist | 730 Tenney Street, Kewanee, IL 61443 | 2006-10-06 |
| 1205927464 | Gordon M Pointer | Chiropractor | 627 East 2nd St, Kewanee, IL 61443 | 2006-09-27 |
| 1699887729 | Stephen L Rider | Dentist | 125 West South Street, Suite #10, Kewanee, IL 61443 | 2006-08-31 |
| 1336153121 | Kelli E Rashid | Occupational Therapist | 125 South Street, Suite B, Kewanee, IL 61443 | 2006-07-28 |
| 1740247394 | Jon A Debord | Physical Therapist | 125 South St, Suite B, Kewanne, IL 61443 | 2006-04-27 |
| Find all providers in zip 61443 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164764635 | Regional Health Partners, LLC | Family Medicine | 1258 W South St Ste 2, Kewanee, IL 61443-8300 | 2013-03-22 |
| 1114036308 | Ahearn & Associates Medical Center, Inc | Family Medicine | 513 Elliott St, Suite 4, Kewanee, IL 61443-2797 | 2006-08-30 |
| 1417964578 | Flor Velasco Evangelista | Family Medicine | 615 Hollis St, Kewanee, IL 61443-3730 | 2006-08-02 |
| 1184687717 | Michael A Ahearn | Family Medicine | 519 Elliott St, Suite S1, Kewanee, IL 61443-2796 | 2006-04-06 |
| 1467866673 | Hayley Ralph | Family Medicine | 1051 W South St, Kewanee, IL 61443 | 2014-06-16 |
| 1700098845 | Crystal Snider | Family Medicine | 1258 W South St, Suite 2, Kewanee, IL 61443-8300 | 2007-05-03 |
| 1356446652 | Regional Family Health Center | Family Medicine | 125 W South St, Suite 12, Kewanee, IL 61443-3715 | 2006-09-13 |
| 1942319124 | Karol Ruth O'neill | Family Medicine | 519 Elliott St, Suite S1, Kewanee, IL 61443-2796 | 2006-08-30 |
| 1982629044 | Julio Ramos | Family Medicine | 719 Elliott St, Kewanee, IL 61443-2779 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558969964 | Nicole Kerner | Family Medicine | 310 Brandy Dr, Mackinaw, IL 61755-9707 | 2020-10-16 |
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1790390805 | Kimberly Hannah Kupferberg | Family Medicine | 1103 Schaeffer Rd, Long Grove, IL 60047-5153 | 2020-09-15 |
| 1194330977 | Home Doctors for You | Family Medicine | 670 Illinois Blvd, Hoffman Est, IL 60169-3363 | 2020-09-09 |
| 1245844489 | Jovita Zalwango Nassolo | Family Medicine | 116 1/2 N Benton St Apt 2d, Woodstock, IL 60098-3272 | 2020-09-04 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1417565755 | Ghr Total Health and Consulting | Family Medicine | 11336 Mckenna Dr, Frankfort, IL 60423-8096 | 2020-07-22 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| Find all providers with the same taxonomy | ||||
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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.