ANTHONY JACKSON (NPI# 1972917037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972917037 |
| Entity Type | Individual |
| Full Name | ANTHONY JACKSON |
| Practice Address |
1015 Waterwood Pkwy Edmond OK 73034-5327 |
| Mailing Address |
Po Box 18883 Oklahoma City OK 73154-0883 |
| Practice Telephone | 4058848085 |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2014-06-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 101Y00000X | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689287328 | Anthony Benedict Jackson | Nurse Practitioner | 8 Radford St # 202, Christiansburg, VA 24073-3320 | 2020-08-24 |
| 1558741652 | Anthony Jackson | Case Manager/Care Coordinator | 2000 Nw 1st St, Boynton Beach, FL 33435-2286 | 2015-06-03 |
| 1922410448 | Anthony Jerome Jackson | Counselor | 1826 Chelsea Rd, Elkins Park, PA 19027-1056 | 2014-06-02 |
| 1245307073 | Anthony Jackson | Counselor | 2237 River Plaza Dr, Sacramento, CA 95833-3836 | 2006-11-29 |
| 1396838868 | Anthony Haig Jackson | Psychiatry & Neurology | 31 Woodlawn Avenue, Needham, MA 02492 | 2006-10-02 |
| 1346254596 | Anthony D Jackson | Dentist | 512 E Alexander St, Plant City, FL 33563-7165 | 2006-07-27 |
| 1720024847 | Anthony L Jackson IIi | Emergency Medicine | 2575 E Bidwell St Ste 160, Folsom, CA 95630-6446 | 2006-06-20 |
| 1568077535 | Anthony Jackson | Chore Provider | 332 S Decatur Blvd, Las Vegas, NV 89107-2804 | 2020-09-15 |
| 1487210399 | Anthony Jackson | Counselor | 5080 Florence Rd, Murfreesboro, TN 37129-2922 | 2019-05-15 |
| 1063076925 | Anthony Earle Jackson | Student in an Organized Health Care Education/Training Program | 3901 Rainbow Blvd, Kansas City, KS 66160-8500 | 2019-04-26 |
| Street Address |
1015 WATERWOOD PKWY |
| City | EDMOND |
| State | OK |
| Zip Code | 73034-5327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083932859 | Gay Fontaina Willis | Counselor | 1015 Waterwood Pkwy, G-n2, Edmond, OK 73034-5327 | 2010-05-04 |
| 1609278811 | Acheseopalima Ichi | Massage Therapist | 1015 Waterwood Pkwy, Ste. G, Unit G-1, Edmond, OK 73034-5327 | 2014-09-18 |
| 1659709608 | Edmondson Family Therapy | Case Management | 1015 Waterwood Pkwy, Suite G, L-2, Edmond, OK 73034-5327 | 2013-10-29 |
| 1194021824 | Merina K. Joseph | Case Manager/Care Coordinator | 1015 Waterwood Pkwy, Gb2, Edmond, OK 73034-5327 | 2011-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1821616038 | Aaron Michael Gowens | Specialist/Technologist | 015 Wantland Hall 100 University Dr., Edmond, OK 73034 | 2020-07-14 |
| 1043834849 | Paddington Place Lcc | Intermediate Care Facility, Mental Illness | 3225 French Park Drive, Suite 6, Edmond, OK 73034 | 2020-06-08 |
| 1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
| 1740773662 | Healthcare Express, LLP | Family Medicine | 2300 E 2nd St, Edmond, OK 73034 | 2018-06-14 |
| 1427555713 | Sara Nicole Smith | Specialist/Technologist | 100 N University Drive, Attn: Athletic Training Room, Edmond, OK 73034 | 2018-04-12 |
| 1619475084 | Carissa Leigh Brackelsberg | Chiropractor | 3709 E 2nd St, Edmond, OK 73034 | 2018-01-31 |
| 1760996177 | Laurel Michelle Glendening | Physical Therapist | 3531 River Wood Lane, Edmond, OK 73034 | 2017-11-21 |
| 1134643380 | Keith S Quinn | Dentist | 3008 Peaceful Ln, Edmond, OK 73034 | 2017-07-31 |
| Find all providers in zip 73034 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437666260 | Louis Alexander Marull | Counselor | 15704 Traditions Dr, Edmond, OK 73013-1149 | 2018-01-02 |
| 1740715598 | Ryan Hays | Counselor | 620 Nw 178 St., Apt. 4c, Edmond, OK 73012 | 2017-04-28 |
| 1922547348 | Madison Blair Hinson | Counselor | 213 Elwood Dr, Edmond, OK 73013-5212 | 2017-02-17 |
| 1891247102 | Tia Goosby | Counselor | 15901 Vintage Dr, Edmond, OK 73013-1417 | 2016-11-03 |
| 1265988463 | Desmond Nkefua | Counselor | 920 South Boulevard Suit 103, Edmond, OK 73034 | 2016-08-28 |
| 1598123374 | Ohnre Whaley | Counselor | 15209 Himalaya Rdg, Edmond, OK 73013-9208 | 2016-02-08 |
| 1033580055 | Monica Brown | Counselor | 809 Nw 142nd St, Edmond, OK 73013-1962 | 2015-10-16 |
| 1336536051 | Rotasha Lewis | Counselor | 1919 E Second St, Edmond, OK 73034 | 2015-04-21 |
| 1720477565 | Kimberly Magee | Counselor | 16008 Evan Shaw Ct, Edmond, OK 73013-7519 | 2015-01-16 |
| 1104229566 | Amir Salami I | Counselor | 2001 Shamrock Dr, Edmond, OK 73003-4707 | 2014-09-30 |
| 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.