My Family Doctor, PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME37656 Issued in FL

Legal business name

MY FAMILY DOCTOR, PA

Practice address

111 NW 183Rd St Ste 306
Miami, FL 33169-4599

Phone

(305) 705-6688

NPI assigned

May 23, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Arnika Renee Jackson

Title

President/Office Manager

Phone

(305) 705-6688

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Jackson Jr., M.D.

  • General Practice Physician
  • Miami, FL
  • NPI 1184607541
  Medicare reassignment NPD

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527033600000",
    "number": "1184115263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NW 183RD ST STE 306",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331694599",
            "telephone_number": "305-705-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NW 183RD ST STE 306",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331694599",
            "telephone_number": "305-705-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY FAMILY DOCTOR, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ARNIKA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRESIDENT/OFFICE MANAGER",
        "authorized_official_telephone_number": "305-705-6688",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME37656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184607541",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• My Dream Alf LLC
• My Drug Store Inc
• My Endo Balance LLC
• My Family Adult Day Care LLC
• My Family Counseling Group
• My Family Home Alf II
• My Family Home Alf, Inc.
• My Family Home Care LLC
• My Family Home Corp
• My Family Pharmacy & Discount

• General Practice Physician in Miami, FL
• Providers in Miami, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.