Active NPI
Zamekio Jackson
- Intellectual & Developmental Disabilities Psychologist
- Jacksonville, FL
National Provider Identifier
1053740902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- Practice address
- 103 Century 21 Dr
Jacksonville, FL 32216-8116 - Phone
- (904) 389-5592
- NPI assigned
- Nov 1, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | Primary |
Addresses
Primary practice location
103 Century 21 Dr
Jacksonville, FL 32216-8116
Mailing address
103 Century 21 Dr
Jacksonville, FL 32216-8116
Phone (904) 389-5592
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383264000000",
"number": "1053740902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 CENTURY 21 DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322168116",
"telephone_number": "904-389-5592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 CENTURY 21 DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322168116",
"telephone_number": "904-389-5592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ZAMEKIO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-01",
"last_updated": "2013-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.