National Provider Identifier
Jackie Mae Anderson, DO
Jackie Mae Anderson, DO is listed in the NPPES registry with a primary specialty of Emergency Medicine Physician in Rochester, NY and a listed phone number of (585) 275-9555.
Profile Overview
- NPI
- 1447789565
- Provider Type
- Individual
- Primary Specialty
- Emergency Medicine Physician
- Enumeration Date
- June 12, 2017
- Last Updated
- July 07, 2023
Practice Location
- 601 Elmwood Ave
- Rochester, NY 14642-4200
Phone: (585) 275-9555
Mailing Address
- 601 Elmwood Avenue Box 655
- Rochester, NY 14642-8655
Specialties
- Emergency Medicine Physician (207P00000X)
- Emergency Medical Services (Emergency Medicine) Physician (207PE0004X)
- Medical Physician Assistant (363AM0700X)
Endpoints
- janderson230326@direct.urmc.rochester.edu
Direct Messaging Address | Direct | Other | Rochester, NY 14642
Full Record
- NPI
- 1447789565
- Entity Type
- Individual
- Last Name
- Anderson
- First Name
- Jackie
- Middle Name
- Mae
- Name Prefix
- Dr.
- Credential
- DO
- Provider Other Last Name
- Grimes
- Provider Other First Name
- Jackie
- Provider Other Middle Name
- Mae
- Provider Other Name Prefix Text
- MS.
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 601 Elmwood Avenue Box 655
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14642-8655
- Mailing Country
- US
- Mailing Phone
- (585) 273-4398
- Practice Street Address
- 601 Elmwood Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14642-4200
- Practice Country
- US
- Practice Phone
- (585) 275-9555
- Practice Fax
- (585) 473-3516
- Enumeration Date
- June 12, 2017
- Last Updated
- July 07, 2023
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- September 07, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Emergency Medicine Physician (207P00000X), Emergency Medical Services (Emergency Medicine) Physician (207PE0004X), Medical Physician Assistant (363AM0700X)