Theresa G Jackson (NPI# 1245239227, PAC ID# 3779642368) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1245239227 |
| PAC ID by PECOS | 3779642368 |
| Professional Enrollment ID | I20081112000066 |
| Full Name | Theresa G Jackson |
| Organization Legal Name | MARYVIEW HOSPITAL |
| Address |
2012 Meade Pkwy Suffolk VA 23434-4259 |
| Phone Number | 7576735680 |
| Gender | F |
| Medical School | EASTERN VIRGINIA MEDICAL SCHOOL |
| Graduation Year | 1989 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Group Practice PAC ID | 5799685632 |
| Number of Group Practice Members | 142 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490017 | BON SECOURS MARYVIEW MEDICAL CENTER |
| 490044 | SENTARA OBICI HOSPITAL |
| 490011 | BON SECOURS DEPAUL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3636 High St, Portsmouth, VA 23707-3236 | MARYVIEW HOSPITAL | |
| Mast 1040 University Blvd, Suite 200, Portsmouth, VA 23703-2650 | 7573976930 | MARYVIEW HOSPITAL |
| 2012 Meade Pkwy, Suffolk, VA 23434-4259 | 7576735680 | MARYVIEW HOSPITAL |
| Organization Legal Name | MARYVIEW HOSPITAL |
| Physicians | 155 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Taylor Brockman | Nurse Practitioner | Maryview Hospital | 148 Burnetts Way, Suite 107, Suffolk, VA 23434-6149 |
| Christianne Hayes | Nurse Practitioner | Maryview Hospital | 2897 Bridge Rd, Suffolk, VA 23435-1799 |
| Louisa A Ayafor | Psychiatry | Maryview Hospital | 3636 High St, Portsmouth, VA 23707-3236 |
| Jessica V Wood | Nurse Practitioner | Maryview Hospital | 3315 High St, Portsmouth, VA 23707-3319 |
| Ashley Lans | Nurse Practitioner | Maryview Hospital | 2613 Taylor Rd, Suite 201, Chesapeake, VA 23321-2246 |
| Haresh D Patel | Pulmonary Disease | Maryview Hospital | 1040 University Blvd, Suite 205, Chesapeake, VA 23321 |
| Faisal Siddiqui | Pulmonary Disease | Maryview Hospital | 4053 Taylor Rd N, Chesapeake, VA 23321-5526 |
| Brandee Leigh Winkler | Physician Assistant | Maryview Hospital | 2012 Meade Pkwy, Suffolk, VA 23434-4259 |
| Shannon M Lassiter | Nurse Practitioner | Maryview Hospital | 7185 Harbour Towne Pkwy, Suite 206, Suffolk, VA 23435-3656 |
| Barbara Sarris | Internal Medicine | Maryview Hospital | 301 Goode Way, Portsmouth, VA 23704-2266 |
| Street Address |
2012 MEADE PKWY |
| City | SUFFOLK |
| State | VA |
| Zip | 23434-4259 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brandee Leigh Winkler | Physician Assistant | Maryview Hospital | 2012 Meade Pkwy, Suffolk, VA 23434-4259 |
| Michael Andrew Caines | Orthopedic Surgery | Maryview Hospital | 2012 Meade Pkwy, Suffolk, VA 23434-4259 |
| Ernesto Luciano Perez | Orthopedic Surgery | Maryview Hospital | 2012 Meade Pkwy, Suffolk, VA 23434-4259 |
| Jon Christopher Brillhart | Physician Assistant | Maryview Hospital | 2012 Meade Pkwy, Suffolk, VA 23434-4259 |
| Sarah M Milosek | Physician Assistant | Maryview Hospital | 2012 Meade Pkwy, Suffolk, VA 23434-4259 |
| Rebecca K Sweede | Nurse Practitioner | Maryview Hospital | 2012 Meade Pkwy, Suffolk, VA 23434-4259 |
| Mark B Kerner | Orthopedic Surgery | Maryview Hospital | 2012 Meade Pkwy, Suffolk, VA 23434-4259 |
| Lora C Blount | Nurse Practitioner | Maryview Hospital | 2012 Meade Pkwy, Suffolk, VA 23434-4259 |
| Nickolas L Pezzella | Physical Medicine and Rehabilitation | Maryview Hospital | 2012 Meade Pkwy, Suffolk, VA 23434-4259 |
| Jason R Miller | Physician Assistant | Maryview Hospital | 2012 Meade Pkwy, Suffolk, VA 23434-4259 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tysheena Lanee Jones | Nurse Practitioner | 4209 Ravine Gap Dr, Suffolk, VA 23434-3055 | |
| Geranameo Vladmire Bullock | Psychiatry | Charis Mental Health Pllc | 2470 Pruden Blvd, Suffolk, VA 23434-4206 |
| Lakeisha Keneti | Nurse Practitioner | Charis Mental Health Pllc | 2470 Pruden Blvd, Suffolk, VA 23434-4206 |
| Thamiris V Palacios-kibler | Allergy/immunology | John R. Sweeney, Jr., M.d. Pllc | 2453 Pruden Blvd, Suffolk, VA 23434-4235 |
| Alice V Wilkins-bryson | Nurse Practitioner | John R. Sweeney, Jr., M.d. Pllc | 2453 Pruden Blvd, Suffolk, VA 23434-4235 |
| John R Sweeney Jr. | Allergy/immunology | John R. Sweeney, Jr., M.d. Pllc | 2453 Pruden Blvd, Suffolk, VA 23434-4235 |
| Gary Brinkley | Physician Assistant | Franklin Clinic Corp | 2000 Meade Pkwy, Suffolk, VA 23434-4259 |
| Gary Sajko | Ophthalmology | Schneider Eye Physicians P C | 2016 Meade Pkwy, Suffolk, VA 23434-4259 |
| Susan C Vick | Occupational Therapy | Tidewater Physical Therapy LLC | 2007 Meade Pkwy, Suffolk, VA 23434-4259 |
| Jane Derrig | Rheumatology | Bayview Physician Services PC | 2000 Meade Pkwy, Suffolk, VA 23434-4259 |
| Find all physicians in zip 23434 | |||
| City | SUFFOLK |
| Zip Code | 23434 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | SUFFOLK + PHYSICAL MEDICINE AND REHABILITATION |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.