MS. LISA CHANEL JACKSON (NPI# 1912923996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912923996 |
| Entity Type | Individual |
| Full Name | MS. LISA CHANEL JACKSON |
| Credential | M.D. |
| Practice Address |
3310 Magnolia St Orangeburg SC 29115-1466 |
| Practice Telephone | 8035316900 |
| Practice Fax Number | 8035316907 |
| Mailing Telephone | 8035316900 |
| Mailing Fax Number | 8035316907 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2011-05-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 036113699 | IL | Allopathic & Osteopathic Physicians |
| Y | 207V00000X | Obstetrics & Gynecology | 33355 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036113699 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598300329 | Lisa Ann Jackson | Speech-Language Pathologist | 802 S Yucatan Dr, Tucson, AZ 85710-4933 | 2019-11-15 |
| 1194292441 | Lisa Jackson | Nurse's Aide | 2423 Montana Blue Dr, Spring, TX 77373-7871 | 2018-10-25 |
| 1770027781 | Lisa Jackson | Registered Nurse | 1520 E Calhoun St, Anderson, SC 29621-2210 | 2016-12-09 |
| 1154711166 | Lisa Jackson | Psychologist | 20111 Horace Harding Expy, Oakland Gardens, NY 11364-1639 | 2015-01-28 |
| 1720493224 | Lisa Nicole Jackson | Specialist/Technologist | 3200 Troup Hwy Ste, 120, Tyler, TX 75701 | 2014-06-24 |
| 1831468420 | Lisa Nicole Jackson | Licensed Practical Nurse | 1599 Prospect Pl Apt 1e, Brooklyn, NY 11233-4451 | 2011-12-28 |
| 1992023030 | Lisa Jackson | Massage Therapist | 7200 Sw 8th Ave Apt 9, Gainesville, FL 32607-1883 | 2010-05-13 |
| 1487844973 | Lisa Nicole Jackson | Obstetrics & Gynecology | 89-06 135th St, Room 6a, Jamaica, NY 11418 | 2007-07-31 |
| 1497828826 | Lisa Lanette Jackson | Nurse Practitioner | 1117 Chestnut St, Lewisville, AR 71845 | 2006-11-15 |
| 1972696516 | Lisa Thompson Jackson | Nurse Anesthetist, Certified Registered | 1500 E. Woodrow Wilson, Jackson, MS 39216 | 2006-10-02 |
| Street Address |
3310 MAGNOLIA ST |
| City | ORANGEBURG |
| State | SC |
| Zip Code | 29115-1466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316911225 | Penelope Jean Bowman | Advanced Practice Midwife | 3310 Magnolia St, Orangeburg, SC 29115-1466 | 2006-02-15 |
| 1992328157 | Angelia R Simpson | Registered Nurse | 3310 Magnolia St, Orangeburg, SC 29115-1468 | 2020-05-22 |
| 1255988697 | Lauren Marie Svensen | Nurse Practitioner | 3310 Magnolia St, Orangeburg, SC 29115-1466 | 2019-08-21 |
| 1790331114 | Brittany Kohn | Nurse Practitioner | 3310 Magnolia St, Orangeburg, SC 29115-1466 | 2019-08-12 |
| 1457917775 | Asha Charmaine Givens | Social Worker | 3310 Magnolia St, Orangeburg, SC 29115-1466 | 2019-05-13 |
| 1225591241 | David Kenneth Marple | Dentist | 3310 Magnolia St, Orangeburg, SC 29115-1466 | 2019-04-08 |
| 1215423975 | Kayla Sanders | Nurse Practitioner | 3310 Magnolia St, Orangeburg, SC 29115-1466 | 2018-07-06 |
| 1104312214 | Melanie Kittrell | Midwife | 3310 Magnolia St, Orangeburg, SC 29115 | 2018-07-02 |
| 1518473420 | Sherry Jones | Advanced Practice Midwife | 3310 Magnolia St, Orangeburg, SC 29115-1466 | 2017-12-15 |
| 1235643248 | Breanna J Linder | Social Worker | 3310 Magnolia St, Orangeburg, SC 29115-1466 | 2017-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306326640 | Orange Cut Rate Drug Store, Inc | General Practice | 1326 Grove Park Dr, Orangeburg, SC 29115 | 2018-08-16 |
| 1821528639 | Shonta Tenisha Westbury | Speech-Language Pathologist | 1890 Dellwood Drive, Orangeburg, SC 29115 | 2017-06-14 |
| 1356870794 | All Your Needs Home Care Services, LLC | Respite Care | 133 Boulevard Street, Orangeburg, SC 29115 | 2017-06-08 |
| 1376090860 | Hanna Bozard | Pharmacist | 332 Stone Wall Jackson Blvd, Orangeburg, SC 29115 | 2016-09-01 |
| 1417309956 | Marian Mitchell Oliver Corp. | Dentist | 939 Jc Calhoun Drive, Orangeburg, SC 29115 | 2016-07-08 |
| 1750766119 | Holly Able | Pharmacist | 332 Stonewall Jackson Blvd., Orangeburg, SC 29115 | 2015-07-28 |
| 1104211234 | Sheryl Durant Singleton | Nurse Practitioner | 1857 Joe S Jeffords Hwy, Orangeburg, SC 29115 | 2015-04-06 |
| 1982012696 | Jeremy Morry Eith | Specialist/Technologist | 300 College Street, Orangeburg, SC 29115 | 2014-07-25 |
| 1629495841 | Kathy Beeks | Registered Nurse | 1550 Carolina Avenue, Carolina Avenue, Orangeburg, SC 29115 | 2014-03-26 |
| 1538509534 | Thomas Charles Haynes Jr. | Audiologist | 1655 Carolina Ave., Orangeburg, SC 29115 | 2013-07-05 |
| Find all providers in zip 29115 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356478952 | Connors Healthcare for Women Pa | Obstetrics & Gynecology | 1181hutto Road, Orangeburg, SC 29118 | 2007-02-28 |
| 1124112446 | Malca M. Sane | Obstetrics & Gynecology | 18 Woodland Ter, Orangeburg, NY 10962-2318 | 2006-10-03 |
| 1770547895 | Whitney Wolfe Thoma | Obstetrics & Gynecology | 1175 Cook Road, Suite 145, Orangeburg, SC 29118-8235 | 2006-04-14 |
| 1487624292 | Susan K. Connor | Obstetrics & Gynecology | 1181 Hutto Road, Orangeburg, SC 29118-8204 | 2006-01-24 |
| 1972939957 | The Regional Medical Center of Orangeburg and Calhoun Counties | Obstetrics & Gynecology | 2850 Pelham Ct, Orangeburg, SC 29118-1400 | 2013-09-23 |
| 1669654448 | Jerome B Degen | Obstetrics & Gynecology | 1175 Cook Rd, Suite 305, Orangeburg, SC 29118-8201 | 2007-12-03 |
| 1043245590 | Drs Williamson & Gillespie Pa | Obstetrics & Gynecology | 1175 Cook Road, Suite 145, Orangeburg, SC 29118 | 2006-07-12 |
| 1952336406 | David W Gillespie | Obstetrics & Gynecology | 1175 Cook Rd, Suite 145, Orangeburg, SC 29118-8201 | 2006-07-12 |
| 1467407155 | Edisto Obgyn Pa | Obstetrics & Gynecology | 1175 Cook Rd, Suite 305, Orangeburg, SC 29118 | 2006-05-23 |
| 1720045644 | Sabrina A Hanna | Obstetrics & Gynecology | 3310 Magnolia St, Orangeburg, SC 29115-1466 | 2006-04-26 |
| Find all providers in ORANGEBURG | ||||
| City | ORANGEBURG |
| Zip Code | 29115 |
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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.