DR. YVONNE MARIE JACKSON (NPI# 1790786101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790786101 |
| Entity Type | Individual |
| Full Name | DR. YVONNE MARIE JACKSON |
| Credential | M.D. |
| Practice Address |
14300 Gallant Fox Ln Suite 203 Bowie MD 20715-4003 |
| Practice Telephone | 3012624784 |
| Practice Fax Number | 3012622767 |
| Mailing Telephone | 3012624784 |
| Mailing Fax Number | 3012622767 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2011-04-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | D50706 | MD | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568728988 | Yvonne Ann Jackson | Case Manager/Care Coordinator | 1816 Nw Sheridan Rd, Lawton, OK 73505-3954 | 2012-04-10 |
| 1992008031 | Yvonne Pamela Jackson | Massage Therapist | 7310 Sw 8th Ct, North Lauderdale, FL 33068-2305 | 2010-12-13 |
| 1083892202 | Yvonne Jackson | Registered Nurse | 36 Shrewsbury Dr, Long Branch, NJ 07740-7619 | 2008-02-11 |
| 1689660318 | Yvonne Emily Jackson | Nurse Practitioner | 1445 Veterans Memorial Circle, Sutter County Health Dept Clinic, Yuba City, CA 95993 | 2005-09-27 |
| 1689225344 | Yvonne Jackson | Technician | 911 N Buffalo Dr Unit 210, Las Vegas, NV 89128-0381 | 2019-09-24 |
| 1144611948 | Yvonne Jackson | Marriage & Family Therapist | 9567 Arrow Rte, Ste M, Rancho Cucamonga, CA 91730-4550 | 2015-02-15 |
| 1013258490 | Yvonne Jackson | Counselor | 1901 S Jones Blvd, Las Vegas, NV 89146-1260 | 2013-03-08 |
| 1417297714 | Yvonne Denise Jackson | Physical Therapist | 1000 Oakland Dr Fl 3, Kalamazoo, MI 49008 | 2013-02-22 |
| 1851664031 | Yvonne Ruth Jackson | Counselor | 4616 W Sahara Ave, 358, Las Vegas, NV 89102-3654 | 2012-02-17 |
| 1104853837 | Yvonne Woodford Jackson | Nurse Anesthetist, Certified Registered | 2600 Sixth Street Sw, Ohio Hospital Based Physician Corp, Canton, OH 44710 | 2006-06-27 |
| Street Address |
14300 GALLANT FOX LN SUITE 203 |
| City | BOWIE |
| State | MD |
| Zip Code | 20715-4003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154322659 | Theodore W Taber | Chiropractor | 14300 Gallant Fox Ln, Suite 201, Bowie, MD 20715-4003 | 2005-08-09 |
| 1598318545 | Bonita Mannings | Counselor | 14300 Gallant Fox Ln, Bowie, MD 20715-4003 | 2019-07-18 |
| 1740796945 | Tierra Shanel Thomas | Nurse Practitioner | 14300 Gallant Fox Ln, Bowie, MD 20715-4003 | 2017-12-26 |
| 1821532813 | Neuroscience Associates of Bowie | Clinical Neuropsychologist | 14300 Gallant Fox Ln, 107, Bowie, MD 20715-4003 | 2016-12-09 |
| 1285082644 | Trinity Dental Care, LLC | Dentist | 14300 Gallant Fox Ln, Suite 111, Bowie, MD 20715-4003 | 2016-05-26 |
| 1285094094 | Love Kids LLC | Pediatrics | 14300 Gallant Fox Ln, 203, Bowie, MD 20715-4003 | 2016-03-07 |
| 1417322926 | Shannon Nicole Martin | Nurse Practitioner | 14300 Gallant Fox Ln, Suite 216, Bowie, MD 20715-4003 | 2015-12-09 |
| 1134598394 | Phs Multispecialty Services | Surgery | 14300 Gallant Fox Ln, Suite 224, Bowie, MD 20715-4003 | 2015-09-17 |
| 1780078436 | Utopia Health Services Group Inc. | Counselor | 14300 Gallant Fox Ln, Suite 213, Bowie, MD 20715-4003 | 2015-03-19 |
| 1083018832 | Marsha Ross | Social Worker | 14300 Gallant Fox Ln, Suite 216, Bowie, MD 20715-4003 | 2014-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104304757 | Aynia V Dorsey | Occupational Therapist | 6915 Laurel Bowie Rd Ste 205b, Bowie, MD 20715 | 2018-08-04 |
| 1558852988 | Dmv Foot and Ankle Center | Podiatrist | 15480 Annapolis Rd Ste 202-437, Bowie, MD 20715 | 2018-05-22 |
| 1861918435 | Ryan Leigh Brown | Psychologist | 3231 Superior Lane, Suite, A6, Bowie, MD 20715 | 2017-08-16 |
| 1073060430 | Chinwendu Ezeoru | Nurse Practitioner | 13004 Viewpoint Ln, Bowie, MD 20715 | 2016-09-02 |
| 1386094977 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 15501 Annapolis Rd, Suite 400, Bowie, MD 20715 | 2016-06-15 |
| 1083003164 | Megan Elizabeth Cooper | Social Worker | 2812 Bosworth Ln, Bowie, MD 20715 | 2015-01-13 |
| 1467856740 | Nathan-todd Consulting | Community/Behavioral Health | 3231 Superior Court Lane,# A5, Bowie, MD 20715 | 2014-10-15 |
| 1841534468 | Varsity Professional Rehabilitation and Staffing, LLC | Physical Therapist | 14000 Jericho Park Road, Bowie, MD 20715 | 2012-11-20 |
| 1013269893 | Felix Chukwudi Ohams | Registered Nurse | 7613 Old Chapel Dr, Bowie, MD 20715 | 2012-10-04 |
| 1720336464 | Tara Marie Hatfield | Physical Therapist | 100 Whitemarsh Park Drive, Bowie, MD 20715 | 2012-08-28 |
| Find all providers in zip 20715 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457389892 | Jeannine Avis Clark | Pediatrics | 6915 Laurel Bowie Road, Suite 301, Bowie, MD 20715 | 2006-06-28 |
| 1275513053 | Valorie Anlage | Pediatrics | 17001 Science Drive, Suite 116, Bowie, MD 20715 | 2006-01-18 |
| 1144229667 | Toni Lynn Thompson-chittams | Pediatrics | 4357 Northview Dr, Bowie, MD 20716-2603 | 2005-07-18 |
| 1083610760 | Amina T Watson | Pediatrics | 1700 Science Drive, Suite 102, Bowie, MD 20715 | 2005-06-27 |
| 1285094094 | Love Kids LLC | Pediatrics | 14300 Gallant Fox Ln, 203, Bowie, MD 20715-4003 | 2016-03-07 |
| 1700266962 | Tlc Pediatrics | Pediatrics | 4357 Northview Dr, Bowie, MD 20716-2603 | 2015-06-03 |
| 1841408697 | Ettienne's Premier Pediatric Care LLC | Pediatrics | 2905 Mitchellville Rd, Ste 115, Bowie, MD 20716-1385 | 2007-05-17 |
| 1730252594 | Suzette Scipio - Ettienne | Pediatrics | 2905 Mitchellville Rd, Ste 115, Bowie, MD 20716-1385 | 2006-11-17 |
| 1770689416 | Azar Dashti | Pediatrics | 4379 Northview Dr, Bowie, MD 20716-2603 | 2006-09-16 |
| 1285648667 | Brenda Karen Pettus-bellamy | Pediatrics | 6915 Laurel Bowie Rd, Suite 301, Bowie, MD 20715 | 2006-07-28 |
| Find all providers in BOWIE | ||||
Please comment or provide details below to improve the information on DR. YVONNE MARIE 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.