BRENT D JACKSON (NPI# 1962418210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962418210 |
| Entity Type | Individual |
| Full Name | BRENT D JACKSON |
| Credential | MD |
| Practice Address |
700 S Highway 99 #3 Fillmore UT 84631-5134 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 4357435555 |
| Mailing Telephone | 4357435555 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2010-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 1638281205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457559353 | Brent Armstrong Jackson | Counselor | 3377 E Bluff Point Dr, Ozark, MO 65721-6691 | 2007-07-03 |
| 1386168847 | Brent Caleb Jackson | Occupational Therapy Assistant | 1100 Grandview Dr, Flatwoods, KY 41139-1024 | 2017-07-26 |
| 1447665013 | Brent Jackson | Dentist | 456 S Main St, Lapeer, MI 48446-2427 | 2014-06-23 |
| 1518301597 | Brent L Jackson | Social Worker | 1031 W Sanetta St, Nampa, ID 83651-5047 | 2013-04-22 |
| 1063790921 | Brent A Jackson | Counselor | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2011-07-26 |
| 1336375138 | Brent A Jackson | Dentist | 1910 State Highway 43 E, Henderson, TX 75652-9106 | 2009-06-08 |
| 1346229382 | Brent Clarence Jackson | Surgery | 2 W Fern Ave, Redlands, CA 92373-5916 | 2006-01-10 |
| Street Address |
700 S HIGHWAY 99 #3 |
| City | FILLMORE |
| State | UT |
| Zip Code | 84631-5134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740780964 | Brian Joseph Huber | Nurse Practitioner | 700 S Highway 99, Fillmore, UT 84631-5134 | 2018-02-14 |
| 1235640343 | Jana Lynn Orton | Social Worker | 700 S Highway 99, Fillmore, UT 84631-5134 | 2017-10-16 |
| 1023159381 | Ihc Health Services Inc | Obstetrics & Gynecology | 700 S Highway 99, #3, Fillmore, UT 84631-5134 | 2007-02-09 |
| 1003822909 | Wayne O Brown | Family Medicine | 700 S Highway 99, #3, Fillmore, UT 84631-5134 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912181967 | Jackson Eye Care, Inc | Optometrist | 210 S 100 W, Fillmore, UT 84631 | 2007-12-27 |
| 1275726788 | Delta Physical Therapy and Sports Medicine PC | Occupational Therapist | 770 S Highway 99, Suite A, Fillmore, UT 84631 | 2007-08-20 |
| 1205957586 | Marilee Wood | Counselor | 65 West Center, Fillmore, UT 84631 | 2007-04-03 |
| 1124148424 | Merla Rutherford | Counselor | 65 W Center, Fillmore, UT 84631 | 2007-03-30 |
| 1609901818 | Linda Stephenson | Registered Nurse | 50 South 400 West, Fillmore, UT 84631 | 2007-02-21 |
| 1750466678 | Jan Bruce Beckstrand | Dentist | 140 South Main Street, Fillmore, UT 84631 | 2006-10-26 |
| 1023025939 | Jon Y. Moody | Dentist | 55 S Main, #3, Fillmore, UT 84631 | 2006-08-02 |
| 1710993506 | Central Utah Mental Health Substance Abuse | Counselor | 65 West Center Street, Fillmore, UT 84631 | 2006-07-31 |
| 1467865840 | Scott Robert Allen | Physical Therapist | 770 S Highway 99, Fillmore, UT 84631 | 2014-06-03 |
| 1851632095 | Jacob D Finlinson, D.d.s, LLC | Dentist | 140 South Main, Fillmore, UT 84631 | 2013-03-13 |
| Find all providers in zip 84631 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487204863 | Mikael Hakansson, M.d. Corp. | Family Medicine | 533 Sespe Ave Ste C, Fillmore, CA 93015-1942 | 2019-09-17 |
| 1336254705 | Jorge O Bautista | Family Medicine | 427 Central Ave, Fillmore, CA 93015-1329 | 2006-08-19 |
| 1265545321 | Nasr N Anees | Family Medicine | 355 Central Avenue, Clinicas Del Camino Real, Inc, Fillmore, CA 93015 | 2006-08-15 |
| 1942245113 | Mikael K Hakansson | Family Medicine | 533 Sespe Ave, Ste #c, Fillmore, CA 93015-1985 | 2006-06-19 |
| 1003854878 | Craig M. Grose | Family Medicine | 716 S Highway 99, Fillmore, UT 84631-5134 | 2006-06-03 |
| 1851339089 | Raymond M Menchaca | Family Medicine | 852 W Ventura St, Fillmore, CA 93015-1837 | 2006-06-02 |
| 1245541952 | Jonathan Scott Bassett | Family Medicine | 674 S Highway 99, Fillmore, UT 84631-5013 | 2010-06-28 |
| 1801070883 | Amelia J Breckenridge | Family Medicine | 828 W Ventura St, Fillmore, CA 93015-1876 | 2007-12-26 |
| 1629101340 | Bautista Medical Group So Ca Inc | Family Medicine | 427 Central Ave, Fillmore, CA 93015 | 2007-03-13 |
| 1306958897 | Logan K. Bundy | Family Medicine | 533 Sespe Ave, Suite B, Fillmore, CA 93015-1942 | 2006-08-31 |
| Find all providers in FILLMORE | ||||
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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.