NPIMap

Organization Active NPI

Jackson Feild Homes

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Jarratt, VA
National Provider Identifier
1194000430
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
1376-05-001 Issued in VA
Legal business name
JACKSON FEILD HOMES
Practice address
546 Walnut Grove Dr
Jarratt, VA 23867-8611
Phone
(434) 634-3217
Fax
(434) 348-3471
NPI assigned
Oct 19, 2011
Last updated
Oct 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name
Mr. Robert E Crane
Title
Cfo
Phone
(434) 634-3217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 1376-05-001 VA Primary

Addresses

Primary practice location

546 Walnut Grove Dr
Jarratt, VA 23867-8611

Mailing address

546 Walnut Grove Dr
Jarratt, VA 23867-8611
Phone (434) 634-3217

Other identifiers 1

IdentifierTypeStateIssuer
1376-05-001MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Jackson Feild Homes4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1194000430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 WALNUT GROVE DR",
            "city": "JARRATT",
            "state": "VA",
            "postal_code": "238678611",
            "telephone_number": "434-634-3217",
            "fax_number": "434-348-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 WALNUT GROVE DR",
            "city": "JARRATT",
            "state": "VA",
            "postal_code": "238678611",
            "telephone_number": "434-634-3217",
            "fax_number": "434-348-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON FEILD HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "CRANE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "434-634-3217",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "1376-05-001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376-05-001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jarratt, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.