CHELSEA JACKSON (NPI# 1881075661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881075661 |
| Entity Type | Individual |
| Full Name | CHELSEA JACKSON |
| Credential | P.A. |
| Practice Address |
2133 Vadalabene Dr Suite 1 Maryville IL 62062-5839 |
| Mailing Address |
Po Box 790 Edwardsville IL 62025-0790 |
| Practice Telephone | 6182884350 |
| Practice Fax Number | 6182884296 |
| Mailing Telephone | 8667246658 |
| Mailing Fax Number | 3149893703 |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-06-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085.005442 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942814736 | Chelsea Jackson | Registered Nurse | 1100 9th Ave, Seattle, WA 98101-2756 | 2020-08-31 |
| 1235786013 | Chelsea Lynn Jackson | Dentist | 2700 Sunset Blvd, Steubenville, OH 43952-1158 | 2019-08-26 |
| 1235622929 | Chelsea Nicole Jackson | Nurse Practitioner | 1100 E Wendover Ave, Greensboro, NC 27405-6713 | 2018-06-07 |
| Street Address |
2133 VADALABENE DR SUITE 1 |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-5839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598841025 | Haresh K Motwani | Emergency Medicine | 2133 Vadalabene Dr, Suite # 5b, Maryville, IL 62062-5839 | 2006-10-27 |
| 1457870131 | Tayler Rae Fazil | Audiologist | 2133 Vadalabene Dr, Maryville, IL 62062-5839 | 2017-09-14 |
| 1013397967 | Katherine Anne Burnley | Nurse Practitioner | 2133 Vadalabene Dr, Suite 5b, Maryville, IL 62062-5839 | 2015-06-05 |
| 1053711895 | Msa Alliance, LLC | Surgery | 2133 Vadalabene Dr, Suite 2, Maryville, IL 62062-5839 | 2014-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295298081 | Corinne S Murphy | Physician Assistant | 6800 State Route 162 # 215, Maryville, IL 62062-8500 | 2019-04-09 |
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1053796227 | Hillary Lynn Tipton | Physician Assistant | 2081 Colonial Cir, Maryville, TN 37803-2678 | 2015-07-29 |
| 1871905794 | Best Weigh Weight Loss Center LLC | Physician Assistant | 1805 W Broadway Ave, Maryville, TN 37801-5511 | 2014-05-27 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1487284360 | Rachel Hannah West | Physician Assistant | 827 E Lamar Alexander Pkwy, Maryville, TN 37804-5001 | 2020-01-20 |
| 1043856701 | Mallory Jean Stimac | Physician Assistant | 6800 State Route 162, Maryville, IL 62062-8521 | 2019-11-18 |
| 1356900492 | Amanda Margaret Altgilbers | Physician Assistant | 6812 State Route 162 Ste 120, Maryville, IL 62062-8586 | 2019-06-12 |
| 1528523719 | Amy Elizabeth Keenan | Physician Assistant | 701 Morganton Square Dr, Maryville, TN 37801-4796 | 2019-02-01 |
| 1891268355 | Eric Michael Watson | Physician Assistant | 6800 State Route 162, Maryville, IL 62062-8521 | 2019-01-08 |
| Find all providers in MARYVILLE | ||||
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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.