NPIMap

Organization Active NPI

Jackson Feild Homes

  • Clinical Social Worker
  • Jarratt, VA
National Provider Identifier
1265699870
Registry record updated Jun 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
278-05 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
May 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 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
Chief Financial Officer
Phone
(434) 634-3217

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 278-05 VA
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 278-05 VA Primary
Mental Illness Community Based Residential Treatment Facility 320800000X 1376-05-001 VA
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X VA

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": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1265699870",
    "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": "2008-05-21",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "CRANE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "434-634-3217",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "278-05",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "278-05",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "VA",
            "license": "1376-05-001",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 16, 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.