JORDAN TYLER JACKSON (NPI# 1891315222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891315222 |
| Entity Type | Individual |
| Full Name | JORDAN TYLER JACKSON |
| Credential | MEDICAL STUDENT |
| Practice Address |
19512 Crest Ridge Dr Edmond OK 73012-3504 |
| Practice Telephone | 9183678128 |
| Mailing Telephone | 9183678128 |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2020-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619583069 | Jordan C Jackson | Chiropractor | 280 Us Highway 9 Ste E, Morganville, NJ 07751-1572 | 2020-09-21 |
| 1639712581 | Jordan Leigh Jackson | Counselor | 1914 5th Ave S, Irondale, AL 35210 | 2019-10-23 |
| 1205285160 | Jordan Aaron Jackson | Family Medicine | 7101 Jahnke Rd # 7151, Richmond, VA 23225-4017 | 2016-06-10 |
| 1942801923 | Jordan Jackson | Behavior Technician | 51145 Nicolette Dr, Chesterfield, MI 48047-4585 | 2020-11-05 |
| 1790396802 | Jordan N Jackson | Dentist | 8955 Wood Rd, Bethesda, MD 20889-5628 | 2020-08-12 |
| 1649881939 | Jordan Michelle Jackson | Behavior Technician | 6925 Parkdale Pl, Indianapolis, IN 46254-4673 | 2020-08-11 |
| 1619501004 | Jordan Jackson | Counselor | 3355 Bee Caves Rd Ste 101, West Lake Hills, TX 78746-6673 | 2020-02-25 |
| 1225598865 | Jordan Van Jackson | Student in an Organized Health Care Education/Training Program | 119 Oakfield Dr, Brandon, FL 33511-5779 | 2019-03-20 |
| 1811462898 | Jordan Jackson | Case Manager/Care Coordinator | 203b Westport Dr, Cabot, AR 72023-3657 | 2018-10-05 |
| 1902382161 | Jordan Jackson | Case Manager/Care Coordinator | 109 Chevy Ln Ste C, Bunkie, LA 71322-1561 | 2018-07-11 |
| Street Address |
19512 CREST RIDGE DR |
| City | EDMOND |
| State | OK |
| Zip Code | 73012-3504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962013912 | Ashley Lambert | Counselor | 19501 N Pennsylvia, Apt 210, Edmond, OK 73012 | 2020-08-13 |
| 1699316083 | First Rate Eye Care Pllc | Optometrist | 1140 Nw 192nd St., Suite A, Edmond, OK 73012 | 2019-10-07 |
| 1659869881 | Brent Byers | Registered Nurse | 3040 Nw 179th Ct, Edmond, OK 73012 | 2018-04-24 |
| 1386173672 | John A Hale | Respiratory Therapist, Certified | 19100 Meadows Crossing Drive, Edmond, OK 73012 | 2017-06-08 |
| 1740715598 | Ryan Hays | Counselor | 620 Nw 178 St., Apt. 4c, Edmond, OK 73012 | 2017-04-28 |
| 1245691336 | Jessica Collins | Behavioral Analyst | 18217 Sandhurst Ct, Edmond, OK 73012 | 2016-03-16 |
| 1538545801 | Cynthia Ann Thompson | Case Manager/Care Coordinator | 1732 Kelly, Edmond, OK 73012 | 2015-08-10 |
| 1538564224 | Function Physical Therapy, LLC | Physical Therapist | 16502 N Pennsylvania Ave, Suite C, Edmond, OK 73012 | 2014-10-24 |
| 1003227414 | Deer Creek Family Healthcare and Wellness Clinic LLC | Clinic/Center | 19401 N. Portland, Edmond, OK 73012 | 2014-05-20 |
| 1316383649 | Ralphs Family Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 1101 Nw178th Street, Suite A, Edmond, OK 73012 | 2013-05-14 |
| Find all providers in zip 73012 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497672 | Colton Want | Student in an Organized Health Care Education/Training Program | 833 San Simeon Dr, Edmond, OK 73003-5943 | 2020-11-06 |
| 1952910143 | Andrew Young | Student in an Organized Health Care Education/Training Program | 1417 Harding Ave, Edmond, OK 73013-6365 | 2020-07-24 |
| 1962024638 | Maaz Khan | Student in an Organized Health Care Education/Training Program | 513 Nw 156th Cir, Edmond, OK 73013-2087 | 2020-05-15 |
| 1942821608 | Shanna Lynne Rolfs | Student in an Organized Health Care Education/Training Program | 1825 Mission Rd, Edmond, OK 73034-6580 | 2020-05-04 |
| 1962023648 | Melissa Onyekuru | Student in an Organized Health Care Education/Training Program | 1720 Nw 179th St, Edmond, OK 73012-4151 | 2020-05-04 |
| 1609497437 | Zachary Scott Windorf | Student in an Organized Health Care Education/Training Program | 7107 Hollow Brook Dr, Edmond, OK 73025-1854 | 2020-05-04 |
| 1275154072 | Raza Khan | Student in an Organized Health Care Education/Training Program | 216 Nw 151st Pl, Edmond, OK 73013-1163 | 2020-05-03 |
| 1164043964 | India Alexandra Loyd | Student in an Organized Health Care Education/Training Program | 1204 Copper Rock Dr, Edmond, OK 73025-2940 | 2020-05-03 |
| 1902427701 | Kelsi Pat Fitzgerrald Williams | Student in an Organized Health Care Education/Training Program | 12924 S Santa Fe Ave, Edmond, OK 73025-1589 | 2020-05-03 |
| 1306467105 | Sawyer Vaclaw | Student in an Organized Health Care Education/Training Program | 14025 N Eastern Ave Apt 2621, Edmond, OK 73013-3512 | 2020-05-03 |
| Find all providers in EDMOND | ||||
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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.