MR. DAVID KENNETH JACKSON (NPI# 1851566467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851566467 |
| Entity Type | Individual |
| Full Name | MR. DAVID KENNETH JACKSON |
| Credential | ABOC |
| Practice Address |
4200 Elderon Ave Baltimore MD 21215-4802 |
| Practice Telephone | 4106644508 |
| Practice Fax Number | 4106640605 |
| Mailing Telephone | 4106644508 |
| Mailing Fax Number | 4106640605 |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
072195 | MD | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003456708 | David Jackson | Clinical Neuropsychologist | 6 Parkway North Blvd, Deerfield, IL 60015-2522 | 2020-01-10 |
| 1194160580 | David Huntsman Jackson | Internal Medicine | 3647 Dunbarton Dr, Mountain Brk, AL 35223-2891 | 2013-04-30 |
| 1790089860 | David Creston Jackson | Dentist | 900 Se Ocean Blvd Ste 110b, Stuart, FL 34994-3503 | 2011-01-05 |
| 1275711350 | David Edward Jackson IIi | Massage Therapist | 3321 E 35th Ave, Lake Station, IN 46405-3016 | 2008-01-31 |
| 1548456502 | David Nathan Jackson | Physical Therapist | 7922 S Broadway Ave, Tyler, TX 75703-5242 | 2007-09-23 |
| 1063564748 | David Bruce Jackson | Radiology | 3233 Grand Ave # N415, Chino Hills, CA 91709-1489 | 2007-01-16 |
| 1912079641 | David Christopher Jackson | Chiropractor | 484 Turner Dr, Building E, Suite 103, Durango, CO 81303-7992 | 2006-11-15 |
| 1316017940 | David Isaac Jackson | Counselor | 946 Edgewood Ave, Trenton, NJ 08618-5304 | 2006-11-09 |
| 1629165170 | David Michael Jackson | Dentist | 3550 S 5600 W, Suite 3, West Valley City, UT 84120-2776 | 2006-10-06 |
| 1366544322 | David Max Jackson | Speech-Language Pathologist | 81 Peregrine Ct, W Lafayette, IN 47906-5073 | 2006-09-01 |
| Street Address |
4200 ELDERON AVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21215-4802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447402193 | Mobile Optical Service, LLC | Eyewear Supplier (Equipment, not the service) | 4200 Elderon Ave, Baltimore, MD 21215-4802 | 2008-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639736796 | Talal Abalkhail | Student in an Organized Health Care Education/Training Program | 2401 W. Belvedere Avenue, Baltimore, Md 21215, Baltimore, MD 21215 | 2019-05-23 |
| 1235795410 | Bilal Khan | Student in an Organized Health Care Education/Training Program | 2041 West Belvedere Avenue, Balitmore, MD 21215 | 2019-05-14 |
| 1669036067 | Nasir M Alhamdan | Student in an Organized Health Care Education/Training Program | Of Baltimore, 2401 West Belvedere Ave, Baltimore, MD 21215 | 2019-05-01 |
| 1851863971 | Brittany Michelle O'neill | Specialist/Technologist | Hearing and Speech Agency, 5900 Metro Drive, Baltimore, MD 21215 | 2018-12-31 |
| 1881164432 | Emily Gamma | Social Worker | 4810 Seton Drive, Baltimore, MD 21215 | 2018-11-27 |
| 1518440478 | Benson Baby | Physical Therapist | 2525west Belveder Ave, Baltimore, MD 21215 | 2018-09-07 |
| 1609360817 | Bonnie Kahler | Clinical Nurse Specialist | 2401 Belvedere Avenue, Baltimore, MD 21215 | 2018-06-20 |
| 1932693843 | Kelley Monica Cohill | Social Worker | Sinai Hospital, Department of Psychiatry, 2440 Cylburn Ave., Baltimore, MD 21215 | 2018-06-15 |
| 1497245609 | Kimberly Beth Koerner | Social Worker | 2401 W. Belvedere Avenue, Baltimore, MD 21215 | 2018-05-14 |
| 1184113078 | Mary Jo Kozel | Registered Nurse | 2401 West Belvedere, Baltimore, MD 21215 | 2018-05-07 |
| Find all providers in zip 21215 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952969503 | Catonsville Vision Partners | Technician/Technologist | 405 Frederick Rd Ste 106, Baltimore, MD 21228-4646 | 2019-05-30 |
| 1215436357 | National Vision. Inc. | Technician/Technologist | 1401 Merritt Blvd # F, Baltimore, MD 21222-2140 | 2018-02-05 |
| 1972017358 | Chippewa Optical LLC | Technician/Technologist | 305 Reisterstown Rd, Baltimore, MD 21208-5313 | 2017-11-21 |
| 1396271433 | Harry Floyd Eichner | Technician/Technologist | 1005 N Point Blvd Ste 704, Baltimore, MD 21224-3402 | 2017-05-11 |
| 1821322710 | Patrick Kelly | Technician/Technologist | 1490 W Patapsco Ave, Baltimore, MD 21230-3400 | 2009-09-24 |
| 1396989265 | America's Best Contacts & Eyeglasses | Technician/Technologist | 1374 Martin Blvd, Baltimore, MD 21220-4104 | 2009-04-23 |
| 1124268156 | America's Best Contacts & Eyeglasses | Technician/Technologist | 300 W Lexington St, Baltimore, MD 21201-3418 | 2009-03-04 |
| 1356541783 | Carolyn Renee Player | Technician/Technologist | 837 N Howard St, 2nd Floor, Baltimore, MD 21201-4699 | 2007-07-24 |
| 1215058961 | Jeffrey Alan Harris | Technician/Technologist | 220 N Basil St, Baltimore, OH 43105-1004 | 2007-04-02 |
| 1225158652 | Pearle Vision Express | Technician/Technologist | 704 B N. Rolling Rd., Baltimore, MD 21228 | 2007-03-30 |
| 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.