Jackson Streeter, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

AZ20619 Issued in AZ

Practice address

13424 SW 4TH LN
Newberry, FL 32669-3050

Phone

(619) 813-6018

NPI assigned

Mar 7, 2013

Last updated

Mar 7, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1154662658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13424 SW 4TH LN",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326693050",
            "telephone_number": "619-813-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13424 SW 4TH LN",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326693050",
            "telephone_number": "619-813-6018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREETER",
        "first_name": "JACKSON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-07",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "AZ20619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Steiner, RN
• Suzanne Stewart Wood, LMT
• Brent T Stewart, M.D., M.B.A.
• Linda Stiles, M.A., CCC-SLP
• Jennifer Stolow, DDS
• Michael Andrew Swart, DPT
• The Orthopaedic Institute, PA (Advanced Pain Medical Center)
• Jean Theurer, PHD
• Brittany Thibault, OTR/L
• Guillermo Rogerio Tinoco Cifuentes, PA

• Family Medicine Physician in Newberry, FL
• Providers in Newberry, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.