Daniel L Jackson (NPI# 1952561938, PAC ID# 6901056258) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1952561938 |
| PAC ID by PECOS | 6901056258 |
| Professional Enrollment ID | I20150701001461 |
| Full Name | Daniel L Jackson |
| Organization Legal Name | MERCY CLINIC MATERNAL FETAL MEDICINE, LLC |
| Address |
621 S New Ballas Rd 2007b Saint Louis MO 63141-8265 |
| Phone Number | 3149515000 |
| Gender | M |
| Medical School | UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE |
| Graduation Year | 2012 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 5294000485 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260020 | MERCY HOSPITAL ST LOUIS |
| Address | Phone | Organization |
|---|---|---|
| 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 | 3149515000 | MERCY CLINIC MATERNAL FETAL MEDICINE, LLC |
| Organization Legal Name | MERCY CLINIC MATERNAL FETAL MEDICINE, LLC |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephanie L Shorey | Nurse Practitioner | Mercy Clinic Maternal Fetal Medicine, LLC | 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 |
| Gary Scott Eglinton | Obstetrics/gynecology | Mercy Clinic Maternal Fetal Medicine, LLC | 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 |
| James A Bartelsmeyer | Obstetrics/gynecology | Mercy Clinic Maternal Fetal Medicine, LLC | 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 |
| Ivana M Vettraino | Obstetrics/gynecology | Mercy Clinic Maternal Fetal Medicine, LLC | 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 |
| Joseph Polcaro | Obstetrics/gynecology | Mercy Clinic Maternal Fetal Medicine, LLC | 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 |
| Asal Fathian | Obstetrics/gynecology | Mercy Clinic Maternal Fetal Medicine, LLC | 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 |
| Carolyn M Martin | Obstetrics/gynecology | Mercy Clinic Maternal Fetal Medicine, LLC | 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 |
| Tara Nicole Banaszek Daming | Obstetrics/gynecology | Mercy Clinic Maternal Fetal Medicine, LLC | 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 |
| Lamia K Atasi | Obstetrics/gynecology | Mercy Clinic Maternal Fetal Medicine, LLC | 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 |
| Jennifer L Hawn | Nurse Practitioner | Mercy Clinic Maternal Fetal Medicine, LLC | 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 |
| Street Address |
621 S NEW BALLAS RD 2007B |
| City | SAINT LOUIS |
| State | MO |
| Zip | 63141-8265 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephanie L Shorey | Nurse Practitioner | Mercy Clinic Maternal Fetal Medicine, LLC | 621 S New Ballas Rd, 2007b, Saint Louis, MO 63141-8265 |
| Stephanie D Nellesen | Nurse Practitioner | Mercy Clinic East Communities | 621 S New Ballas Rd, Suite 189a, Saint Louis, MO 63141-8255 |
| Kathryn L Botney | Obstetrics/gynecology | Mercy Clinic East Communities | 621 S New Ballas Rd, Suite 4005b, Saint Louis, MO 63141-8268 |
| Peter K W Yoon | Neurosurgery | Neurosurgical Specialists of West County Inc | 621 S New Ballas Rd, 297a, St Louis, MO 63141-8200 |
| Troy H Caron | Orthopedic Surgery | Mercy Clinic Trauma and General Surgery LLC | 621 S New Ballas Rd, Suite 560a, Saint Louis, MO 63141-8261 |
| Alpana Chandra | Pulmonary Disease | Mercy Clinic Pulmonology St Louis LLC | 621 S New Ballas Rd, 228a, St Louis, MO 63141-8256 |
| Louis S Brunworth | Plastic and Reconstructive Surgery | Mercy Clinic Burn and Plastic Surgery LLC | 621 S New Ballas Rd, Suite 7008b, Saint Louis, MO 63141-8275 |
| Allison M Creswell | Physician Assistant | Neurosurgical Specialists of West County Inc | 621 S New Ballas Rd, 297a, St Louis, MO 63141-8200 |
| Denis I Altman | Neurology | 621 S New Ballas Rd, 483a, Saint Louis, MO 53141-8259 | |
| Tatiana Ramirez Dominguez | General Surgery | Mercy Clinic Surgical Specialists LLC | 621 S New Ballas Rd, Suite 7011b, Saint Louis, MO 63141-8275 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren M Finnerty | Nurse Practitioner | Associated Physicians Group Ltd | 845 N New Ballas Court, Suite 120, Creve Couer, MO 63141 |
| Enos Moss | Nurse Practitioner | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Matthew Stewart Wilson | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Erica Chick | Clinical Social Worker | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Thomas Horn | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Tianyuan Yin Cornell | Psychiatry | Mercy Clinic Adult Psychiatry LLC | 12125 Conway, Suite 160, St. Louis, MO 63141 |
| Patricia L Tracy | Physical Therapy | Associated Physicians Group, Ltd | 845 N New Ballas Court, Creve Couer, MO 63141 |
| Kevin O Easley | Gynecological Oncology | Mercy Clinic Gyn Oncology LLC | 607 S New Ballas Rd, Suite 2350, Saint Louis, MO 63141-0001 |
| Kelly L Ball | Nurse Practitioner | Mercy Clinic Gyn Oncology LLC | 607 S New Ballas Rd, Suite 2350, Saint Louis, MO 63141-0001 |
| Amy Kelly Neu | Clinical Social Worker | Fitzgibbons Psychological West County Psychological Associates | 12125 Woodcrest Exec Dr, Suite 110, St Louis, MO 63141-5009 |
| Find all physicians in zip 63141 | |||
| City | SAINT LOUIS |
| Zip Code | 63141 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | SAINT LOUIS + OBSTETRICS/GYNECOLOGY |
Please comment or provide details below to improve the information on Daniel L Jackson.
| 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.