DR. JESSICA JACKSON (NPI# 1912947631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912947631 |
Entity Type | Individual |
Full Name | DR. JESSICA JACKSON |
Credential | DPM |
Practice Address |
178 N Ewing Ave Louisville KY 40206-2459 |
Mailing Address |
6200 Pleasant Ave Suite 3 Fairfield OH 45014-4670 |
Practice Telephone | 5025543792 |
Mailing Telephone | 5138299333 |
Mailing Fax Number | 5138587827 |
Enumeration Date | 2006-06-08 |
Last Update Date | 2018-03-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213E00000X | Podiatrist | 00242 | KY | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 200279930 | 05 | |
KY | 80002421 | 05 | |
KY | RAILROAD MEDICARE | P00696482 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
15014 Bircham Rd, Louisville, KY 402454104 | 5025580194 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437759594 | Jessica Ashley Jackson | Social Worker | 310 W Mckinley Ave, Mishawaka, IN 46545-5600 | 2020-10-28 |
1396387361 | Jessica Leeann Jackson | In Home Supportive Care | 2643 Portsmouth Pl, Hephzibah, GA 30815-6434 | 2019-10-11 |
1720638018 | Jessica Jackson | Registered Nurse | 1600 Pine Tree Rd Apt 415, Longview, TX 75604-3244 | 2019-09-18 |
1386106326 | Jessica Marie Jackson | Specialist/Technologist | 120 Main St Apt 217, Saco, ME 04072-3528 | 2019-04-01 |
1205335916 | Jessica Berdette Jackson | Licensed Practical Nurse | 376 Owego Rd, Candor, NY 13743-1645 | 2018-02-08 |
1023553187 | Jessica Elise Jackson | Physician Assistant | 2109 S Santa Fe Ave, Moore, OK 73160-2807 | 2016-12-28 |
1982151130 | Jessica Jackson | Licensed Practical Nurse | 25 Green Knolls Dr Apt D, Rochester, NY 14620-4777 | 2016-09-06 |
1770940975 | Jessica Jackson | Technician, Other | 24024 Evergreen Rd Apt 108a, Southfield, MI 48075-5517 | 2016-01-20 |
1710344007 | Jessica Jackson | Social Worker | 4 Tufts Trl, Hopatcong, NJ 07843-1013 | 2016-01-18 |
1336572726 | Jessica L Jackson | Health Educator | 492 Naughright Rd, Long Valley, NJ 07853-3807 | 2013-08-20 |
Street Address |
178 N EWING AVE |
City | LOUISVILLE |
State | KY |
Zip Code | 40206-2459 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013438746 | Andrew R Bouwkamp | Podiatrist | 178 N Ewing Ave, Louisville, KY 40206-2459 | 2017-07-03 |
1811348808 | Bryant Allen Nachtigall | Podiatrist | 178 N Ewing Ave, Louisville, KY 40206-2459 | 2016-06-30 |
1720477672 | Bluegrass Podiatric Management LLC | Podiatrist | 178 N Ewing Ave, Louisville, KY 40206-2459 | 2015-01-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285243477 | Stephanie Atherton | Nurse Practitioner | 1623 Story Ave, Louisville, KY 40206 | 2020-07-24 |
1023547460 | Jeffrey Obiora | Student in an Organized Health Care Education/Training Program | 500 South Preston St, Room 305, Lousiville, KY 40206 | 2017-06-08 |
1053840710 | Mary Oliver Humke | Lactation Consultant, Non-RN | 155 N Galt Ave, Louisville, KY 40206 | 2017-06-07 |
1417304908 | James Edward Meffert Sr. | Dentist | 1618 Story Ave. (home/office Setting), Louisville, KY 40206 | 2016-05-16 |
1235516527 | Jara Nashelle Vega Velez | Internal Medicine | 800 Zorn Ave Dept Of, Louisville, KY 40206 | 2015-05-06 |
1184058885 | Reba D Ziller | Occupational Therapist | 4604 Lowe Road, Regis Woods Rehab Center, Louisville, KY 40206 | 2013-08-29 |
1407109176 | Jessica L Hoback | Physical Therapy Assistant | 2141 Sycamore Avenue, Louisville, KY 40206 | 2012-10-18 |
1598039315 | Mary Barbara Sowers | Emergency Medicine | 611 Emery Rd, Louisville, KY 40206 | 2012-02-24 |
1053628479 | Adrian J Pellegrini Md | Nurse Practitioner | 170 Crescent Ave, Louisville, KY 40206 | 2010-09-07 |
1518297761 | Kiley Nontell Mcneill | Behavioral Analyst | 1100 East Market St., Louisville, KY 40206 | 2010-01-12 |
Find all providers in zip 40206 |
Taxonomy Code | 213E00000X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578112983 | Peter Cunningham | Podiatrist | 1 Audubon Plaza Dr Ofc L2, Louisville, KY 40217-1318 | 2019-09-09 |
1447787676 | Jenna Vaught LLC | Podiatrist | 3407 Kerry Dr, Louisville, KY 40218-2131 | 2017-05-18 |
1083907471 | Larry K Ketcherside | Podiatrist | 9110 Leesgate Rd, Louisville, KY 40222-5053 | 2011-05-18 |
1558516054 | Jessica S Jackson Dpm Pllc | Podiatrist | 15014 Bircham Rd, Louisville, KY 40245-4104 | 2008-11-25 |
1568625903 | Janine A. Valentino | Podiatrist | 9880 Angies Way Suite 110, Louisville, KY 40241-2943 | 2008-07-07 |
1205055332 | Achillies Foot and Ankle Center Inc | Podiatrist | 317 B Gutherie Green, Louisville, KY 40202 | 2007-04-25 |
1932277274 | John M Miller | Podiatrist | 335 W South Boulder Road, Suite 5, Louisville, CO 80027-1192 | 2006-12-04 |
1366542748 | Steven Richard Shlonsky | Podiatrist | 149 Thierman Lane, Louisville, KY 40207 | 2006-09-25 |
1841397320 | Family Foot and Ankle Care Pllc | Podiatrist | 130 N Evergreen Rd, Suite 102, Louisville, KY 40243-1489 | 2006-09-19 |
1497772255 | Jeffrey Kenneth Marzian | Podiatrist | 3403 Gatecreek Rd, Louisville, KY 40272-2687 | 2006-07-17 |
Find all providers in LOUISVILLE |
City | LOUISVILLE |
Zip Code | 40206 |
Please comment or provide details below to improve the information on DR. JESSICA 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.