Peaches-NA-Basket Adult Health Care Services

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PEACHES-NA-BASKET ADULT HEALTH CARE SERVICES

Doing business as

Peaches-Na-Basket Adult Services

Practice address

2017 Soutel Dr
Jacksonville, FL 32208

Phone

(904) 766-3195

Fax

(904) 330-0762

NPI assigned

Jan 25, 2012

Last updated

Jul 23, 2018By 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

Ms. B. Dolores Flemming, MSA

Title

Ceo

Phone

(904) 766-4993

Specialties & licenses 2

Addresses

Other names 1

• Peaches-Na-Basket Adult Services Doing business as

Tax ID family

Peaches-NA-Basket Adult Health Care Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Peachesnabasket Adult Health Services

  dba PeachesNaBasketAdult Services

  • Point of Service
  • Jacksonville, FL
  • NPI 1841548898
  NPD tax ID

Locations

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1225309040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 SOUTEL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322082280",
            "telephone_number": "904-766-4993",
            "fax_number": "904-766-4993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 SOUTEL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32208",
            "telephone_number": "904-766-3195",
            "fax_number": "904-330-0762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 Soutel Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322082280",
            "country_code": "US",
            "telephone_number": "904-766-4993",
            "fax_number": "904-766-4993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEACHES-NA-BASKET ADULT HEALTH CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "FLEMMING",
        "authorized_official_first_name": "B.",
        "authorized_official_middle_name": "DOLORES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-766-4993",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peaches-Na-Basket Adult Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Peaches-Na-Basket Adult Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kerrie Peacock-Preston, PA-C
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• Assisted Living Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.