Organization Active NPI

Jessie's World Inc

Doing business as Triumph Services

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1255928388
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JESSIE'S WORLD INC
Doing business as
Triumph Services
Practice address
1000 Baxter St Ste 1100
Charlotte, NC 28204-2859
Phone
(980) 263-9670
Fax
(980) 430-4527
NPI assigned
Dec 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Mrs. Renee C Johnson, MS, CBOS
Title
Chief Development Officer
Phone
(980) 263-9670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1000 Baxter St Ste 1100
Charlotte, NC 28204-2859

Mailing address

PO Box 480635
Charlotte, NC 28269-5305
Phone (980) 263-9670

Other names 1

  • Triumph Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241017000614 NC Part B Supplier - Clinic/Group Practice 8729510656 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1255928388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480635",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282695305",
            "telephone_number": "980-263-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BAXTER ST STE 1100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042859",
            "telephone_number": "980-263-9670",
            "fax_number": "980-430-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSIE'S WORLD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF DEVELOPMENT OFFICER",
        "authorized_official_telephone_number": "980-263-9670",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, CBOS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Triumph Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Triumph Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.