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LARRY D JACKSON PA-C
NPI 1912928441
Physician Assistant in Youngstown, OH

Active since July 21, 2006
500 GYPSY LN, YOUNGSTOWN, OH 44504(330) 884-1000 Get Directions Write a Review

NPPES record last updated: November 20, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Larry D Jackson Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LARRY D JACKSON PA-C (NPI 1912928441) is an individual physician assistant in Youngstown, Ohio, licensed in Ohio (50-000351) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1912928441
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameLARRY D JACKSONCredential: PA-C
Location Address500 GYPSY LNYoungstown, OH 44504-1315
Mailing Address16620 Downey Glen TrlBurton, OH 44021-9319
Phone(330) 884-1000
Sole ProprietorYes
Enumeration DateJuly 21, 2006
Last NPPES UpdateNovember 20, 2014
✔ NPI 1912928441 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in OH · 50-000351
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPersonal Emergency Response AttendantTaxonomy 146D00000X · License 50000351 (OH)
500 GYPSY LN, Youngstown, OH 44504
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Other Identifiers 3

Medicare ID-Type UnspecifiedJAPA16719OH
Other970029949OH · Medicare Travelers Rr-ga
Medicare UPINS62128OH

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FORUM HEALTH ENTERPRISES CO
Nurse Practitioner
500 GYPSY LN
YOUNGSTOWN, OH 44504
Mahoning County (330) 884-4570
YOUNGSTOWN OHIO PHYSICIAN SERVICES COMPANY LLC
Internal Medicine
500 GYPSY LN
YOUNGSTOWN, OH 44504
Mahoning County (330) 884-0120
MICHAEL G SAALOUKE MD
Pediatrics (Pediatric Cardiology)
500 GYPSY LN
YOUNGSTOWN, OH 44504
Mahoning County (330) 884-3991
DR. AMANPREET DHALIWAL M.D.
Student in an Organized Health Care Education/Training Program
500 GYPSY LN, FAMILY MEDICINE DEPARTMENT
YOUNGSTOWN, OH 44504
Mahoning County (330) 884-3235
VALLEY CARE
General Acute Care Hospital (Critical Access)
500 GYPSY LN
YOUNGSTOWN, OH 44504
Mahoning County (330) 884-3472
SAHIL RAO MD
Internal Medicine
500 GYPSY LN
YOUNGSTOWN, OH 44504
Mahoning County (773) 796-0061
MS. DONNA ELAINE WARD CRNA
Nurse Anesthetist, Certified Registered
500 GYPSY LN
YOUNGSTOWN, OH 44504
Mahoning County (330) 884-3679
MORRIS W. PULLIAM, M.D., LLC
Neurological Surgery
500 GYPSY LN
YOUNGSTOWN, OH 44504
Mahoning County (330) 773-3544

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Larry Jackson's NPI number?

The NPI number for Larry Jackson is 1912928441. It was assigned to this individual provider in the NPPES registry on July 21, 2006.

Where is Larry Jackson located?

Larry Jackson practices at 500 Gypsy Ln, Youngstown, OH 44504. The listed phone number is (330) 884-1000.

What is Larry Jackson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Larry Jackson was last updated on November 20, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.