DR. JEFFREY A JACKSON (NPI# 1972563443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972563443 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY A JACKSON |
| Credential | MD |
| Practice Address |
720 Eskenzi Ave. Indianapolis IN 46202-5166 |
| Mailing Address |
250 N Shadeland Ave Suite 130 - Provider Enrollment Indianapolis IN 46219-4959 |
| Practice Telephone | 3178804103 |
| Practice Fax Number | 3178800302 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2016-05-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
01062685A | IN | Allopathic & Osteopathic Physicians |
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
G8711 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | CSHCN | 1010571-01 | 01 |
| TX | BLUE SHIELD | 807573 | 01 |
| TX | RR/MEDICARE | 460002994 | 01 |
| TX | 1010571-02 | 05 | |
| IN | 201350760 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578193181 | Jeffrey Jackson | Student in an Organized Health Care Education/Training Program | 1055 W Longfellow Dr, Manteno, IL 60950-9472 | 2020-01-22 |
| 1881259570 | Jeffrey Lamar Jackson II | Chiropractor | 13865 S Dixie Hwy # 307, Miami, FL 33176-7221 | 2019-05-08 |
| 1548753965 | Jeffrey Jackson | Social Worker | 2024 Corporate Centre Dr Ste 103, Myrtle Beach, SC 29577-7410 | 2018-06-11 |
| 1154792422 | Jeffrey Scott Jackson | Occupational Therapy Assistant | 3209 Bristol Hwy., Nhc Healthcare, Johnson City, TN 37601 | 2015-10-13 |
| 1447481205 | Jeffrey Brown Jackson | Marriage & Family Therapist | 450 N University Ave, Suite 204, Provo, UT 84601-2860 | 2009-07-28 |
| 1952421927 | Jeffrey W Jackson | Pharmacist | 5510 Lafayette Rd Ste 260, Indianapolis, IN 46254-1691 | 2007-03-30 |
| 1659432607 | Jeffrey L Jackson | Internal Medicine | 500o W National Ave, Milwaukee, WI 53295-0001 | 2006-12-13 |
| 1760589477 | Jeffrey Scott Jackson | Pharmacist | 16821 Rosman Hwy, Lake Toxaway, NC 28747-9593 | 2006-09-17 |
| 1194764860 | Jeffrey Kline Jackson | Family Medicine | 2200 W Touhy Ave, Chicago, IL 60645-3412 | 2006-06-06 |
| 1033759154 | Jeffrey Frank Jackson | Nurse Anesthetist, Certified Registered | 2142 N Cove Blvd, Toledo, OH 43606-3895 | 2020-01-07 |
| Street Address |
720 ESKENZI AVE. |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46202-5166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386886 | Sara Brooke Horn | Registered Nurse | 1801 N Senate Ave Ste 3300, Indianapolis, IN 46202 | 2020-11-04 |
| 1013521905 | Zachary Camden Grimes | Registered Nurse | 720 Eskenazi Avenute, Indianapolis, IN 46202 | 2020-09-08 |
| 1790314045 | Scott C Mitchell II | Student in an Organized Health Care Education/Training Program | Indiana University School of Medicine Dept of Neurosurg, 355 W. 16th St, Gh 5100, Indianapolis, IN 46202 | 2020-04-07 |
| 1053940676 | James Patrick Kelly Iv | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr., Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1124657697 | Betsy Wilson Stevens | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Drive, Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1093340580 | Brian T Edmonds | Social Worker | Sandra Eskenazi Mental Health Center, 1700 N Illinois St, Indianapolis, IN 46202 | 2020-03-05 |
| 1326683210 | Lindsay Nicole Rich | Nurse Practitioner | 1800 N Senate Ave, Indianapolis, IN 46202 | 2019-11-14 |
| 1427693670 | Ronald Mcdonald House Charities of Central Indiana | Voluntary or Charitable | 435 Limestone Street, Indianaplois, IN 46202 | 2019-11-12 |
| 1790344760 | Kirsten Denise Leaberry | Student in an Organized Health Care Education/Training Program | Iu Health Neuroscience Center, Goodman Hall, 355 West 16th Street, Indianapolis, IN 46202 | 2019-06-12 |
| 1679138093 | Chris Olson Jr. | Student in an Organized Health Care Education/Training Program | 1701 N. Senate Blvd, Ag012, Indianapolis, IN 46202 | 2019-05-02 |
| Find all providers in zip 46202 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679080683 | Gregory Alan Gaich | Internal Medicine | 5891 N New Jersey St, Indianapolis, IN 46220-2534 | 2017-12-29 |
| 1154833002 | Endocrinology & Diabetes of Indiana LLC | Internal Medicine | 9240 N Meridian St Ste 240, Indianapolis, IN 46260-1876 | 2017-11-01 |
| 1669909388 | Primariahealth, PC | Internal Medicine | 9365 Counselors Row Ste 210, Indianapolis, IN 46240-6418 | 2017-05-11 |
| 1083078943 | James K Malone | Internal Medicine | 5256 N Illinois St, Indianapolis, IN 46208-2636 | 2016-04-07 |
| 1124301106 | Charles Malcolm Clark Jr. | Internal Medicine | 2802 Lafayette Road Suite 13, Eagledale Health Center, Indianapolis, IN 46222-2112 | 2011-09-26 |
| 1891920914 | Anne Caroline Kitchens | Internal Medicine | 8435 Clearvista Pl Ste 101, Indianapolis, IN 46256 | 2009-05-19 |
| 1790941383 | Louis Vignati | Internal Medicine | 8515 Olde Mill Circle West Dr, Indianapolis, IN 46260-2372 | 2008-08-03 |
| 1992960140 | Janet Tobian | Internal Medicine | 9121 Walnut Grove Dr, Indianapolis, IN 46236-8533 | 2008-07-26 |
| 1376684993 | Eugene Henry Lamkin Jr. | Internal Medicine | 4145 Washington Blvd, Indianapolis, IN 46205-2616 | 2007-02-08 |
| 1639192743 | Andrew Cagle | Internal Medicine | 7310 Preamble Ct, Indianapolis, IN 46259-5751 | 2006-07-26 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46202 |
Please comment or provide details below to improve the information on DR. JEFFREY A 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.