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GERALD DERAND JACKSON
NPI 1962661363
Military Health Care Provider - Independent Duty Corpsman in Jacksonville, FL

Active since June 02, 2008
2104 MASSEY AVE, JACKSONVILLE, FL 32228(904) 270-4241 Get Directions Write a Review

NPPES record last updated: August 3, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Gerald Derand Jackson NPPES

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

GERALD DERAND JACKSON (NPI 1962661363) is an individual independent duty corpsman provider in Jacksonville, Florida and active in the NPI registry since June 2008.

NPPES Registry Identity

NPI1962661363
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameGERALD DERAND JACKSON
Location Address2104 MASSEY AVEJacksonville, FL 32228
Mailing Address2104 Massey AveJacksonville, FL 32228 · (904) 270-4241
Phone(904) 270-4241
Sole ProprietorNo
Enumeration DateJune 2, 2008
Last NPPES UpdateAugust 3, 2009
✔ NPI 1962661363 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

2104 MASSEY AVE, Jacksonville, FL 32228
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Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

DR. CHRISTOPHER CHARLES LECLAIRE D.D.S
Dentist (General Practice)
2104 MASSEY AVE, NBHC MAYPORT
MAYPORT, FL 32228
Duval County (904) 270-4461
DR. WILLIAM LOPEZ JR. DMD, MS, MPA
Dentist
2104 MASSEY AVE
MAYPORT, FL 32228
Duval County (412) 725-8016
ALLAN H CHEIKEN BSC PHARMACY
Pharmacist
2104 MASSEY AVE
MAYPORT, FL 32228
Duval County (904) 270-4205
MR. WASIM S MOHAMED IDC
Military Health Care Provider (Independent Duty Corpsman)
2104 MASSEY AVE
JACKSONVILLE, FL 32228
Duval County (904) 270-4220
MR. NOEL ANTONIO MARTINEZ IDC
Military Health Care Provider (Independent Duty Corpsman)
2104 MASSEY AVE
JACKSONVILLE, FL 32228
Duval County (904) 270-4474
JUSTIN HOBLET
Physical Therapist
2104 MASSEY AVE
JACKSONVILLE, FL 32228
Duval County (904) 270-4265
EDUARDO CORVISON RN
Registered Nurse (Occupational Health)
2104 MASSEY AVE, NBHC NAVAL STATION MAYPORT
JACKSONVILLE, FL 32228
Duval County (904) 270-4229
DERRICK LAVAR RAYSOR IDC
Military Health Care Provider (Independent Duty Corpsman)
2104 MASSEY AVE
JACKSONVILLE, FL 32228
Duval County (904) 270-4233
DR. FAROOQ DAVID BURHAM PHARMD
Pharmacist (Ambulatory Care)
2104 MASSEY AVE
JACKSONVILLE, FL 32228
Duval County (904) 270-4280
DANIELLE BLEVINS
Dental Hygienist
2104 MASSEY AVE
JACKSONVILLE, FL 32228
Duval County (904) 339-1930
AMANDA MARIE KERLIN CRDH
Dental Hygienist
2104 MASSEY AVE
JACKSONVILLE, FL 32228
Duval County (904) 270-4460
DR. JEFFREY WILLIAM HILLEY D.M.D., M.S.
Dentist (Endodontics)
2104 MASSEY AVE
NS MAYPORT, FL 32228
Duval County (904) 270-4460
STEPHANIE CLAIRE LAWLER CRDH
Dental Hygienist
2104 MASSEY AVE, ROOM 2065
MAYPORT NAVAL STA, FL 32228
Duval County (904) 270-4460
HALEY EMMA VOLANTE IDC
Military Health Care Provider (Independent Duty Corpsman)
2104 MASSEY AVE
MAYPORT, FL 32228
Duval County (413) 388-3743
CARAFAYE BROCKETT
Physical Therapy Assistant
2104 MASSEY AVE
JACKSONVILLE, FL 32228
Duval County (904) 270-4276
DR. BRITTNEY CANNON DMD
Dentist (General Practice)
2104 MASSEY AVE
MAYPORT, FL 32228
Duval County (904) 270-3248
DR. SHAQUITA RENEE AMANQUAH PHARMD
Pharmacist
2104 MASSEY AVE
JACKSONVILLE, FL 32228
Duval County (904) 270-4407
DR. MARY SAVARESE BARNES DO
Military Health Care Provider
2104 MASSEY AVE, BUILDING 2104
JACKSONVILLE, FL 32228
Duval County (904) 270-5947
TASHANA CARTER R.N.
Registered Nurse (Case Management)
2104 MASSEY AVE, BUILDING 2104
JACKSONVILLE, FL 32228
Duval County (904) 270-4430
DR. CHRISTINA JOELENE ERFORD DNP, APRN, NP-C
Nurse Practitioner (Family)
2104 MASSEY AVE
JACKSONVILLE, FL 32228
Duval County (904) 270-4251

Frequently Asked Questions

What is Gerald Jackson's NPI number?

The NPI number assigned to this healthcare provider is 1962661363, enumerated as an "individual" on June 02, 2008.

Where is the provider located?

The provider is located at 2104 MASSEY AVE JACKSONVILLE, FL 32228 and the phone number is (904) 270-4241.

What is the provider's specialty?

Military Health Care Provider with taxonomy code 1710I1002X and a focus in Independent Duty Corpsman.