Jackson Senior Services, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ACL0000000124 Issued in TN

Legal business name

JACKSON SENIOR SERVICES, LLC

Doing business as

Regency Retirement Village

Practice address

420 Cheyenne Dr
Jackson, TN 38305-5412

Phone

(731) 661-9888

Fax

(731) 661-9056

NPI assigned

Nov 10, 2010

Last updated

Nov 10, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Matthew A Ernst

Title

Executive Director

Phone

(731) 661-9888

Specialties & licenses 3

Addresses

Other names 1

• Regency Retirement Village Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1073814893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 CHEYENNE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383055412",
            "telephone_number": "731-661-9888",
            "fax_number": "731-661-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CHEYENNE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383055412",
            "telephone_number": "731-661-9888",
            "fax_number": "731-661-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON SENIOR SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "ERNST",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "731-661-9888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TN",
            "license": "ACL0000000124",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "TN",
            "license": "ACL0000000124",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "TN",
            "license": "ACL0000000124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regency Retirement Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jackson Pathology Group a Professional Corporation
• Jackson Pulmonary Care, PA (JPC Medicine Shoppe)
• Jackson Radiology Associates PA
• Jackson Regional Womens Center
• Jackson Residential, LLC (Alexandria Place)
• Jackson Spa LLC (Jackson Massage and Day Spa)
• Jackson Surgical Associates. PA
• Jackson Tennessee Hospital Company LLC (Tennova Healthcare-Regional Jackson)
• Jackson Transit Authority
• Jackson Urological Associates, P.C.

• Assisted Living Facility in Jackson, TN
• Providers in Jackson, TN by specialty
• Assisted Living Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.