Black Jack Staffing

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

BLACK JACK STAFFING

Practice address

225 Fairway Blvd
Whitehall, OH 43213-2071

Phone

(614) 986-7185

NPI assigned

May 24, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Jackie Doodley Jr.

Title

Ceo

Phone

(614) 588-4436

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1104564731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 FAIRWAY BLVD",
            "city": "WHITEHALL",
            "state": "OH",
            "postal_code": "432132071",
            "telephone_number": "614-986-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 FAIRWAY BLVD",
            "city": "WHITEHALL",
            "state": "OH",
            "postal_code": "432132071",
            "telephone_number": "614-986-7185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK JACK STAFFING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-19",
        "status": "A",
        "authorized_official_last_name": "DOODLEY",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-588-4436",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelique Claire Bermudez, DNP, FNP-C, PMHNP-BC
• Beyond Healthcare & Education, LLC
• Beyond Healthcare Ohio
• James William Bihari, O.D.
• Kathleen Binau, M.S.
• Amanda Black
• Kyle Black
• Deviair Blackwell
• Amy Jo Boeing
• Lucas Robert Boff, PMHNP

• All providers in Whitehall, OH
• In Home Supportive Care Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.