John Ellison Community Recovery Center

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

JOHN ELLISON COMMUNITY RECOVERY CENTER

Practice address

6320 Saint Augustine Rd Ste 9a
Jacksonville, FL 32217-2813

Phone

(904) 661-1985

Fax

(904) 619-0984

NPI assigned

Feb 4, 2020

Organization subpart

No

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

Authorized official

Name

Tekesha Ellison

Title

VP of Operations

Phone

(904) 888-4634

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1306478797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 SAINT AUGUSTINE RD STE 9A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172813",
            "telephone_number": "904-661-1985",
            "fax_number": "904-619-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 SAINT AUGUSTINE RD STE 9A",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172813",
            "telephone_number": "904-661-1985",
            "fax_number": "904-619-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN ELLISON COMMUNITY RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "TEKESHA",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "904-888-4634"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Assi, MD, PA
• John Assi, MD, PA
• John Assi, MD, PA
• John Assi, MD, PA
• John C. Derickson OD, PA
• John Goetze Physical Therapy, Inc
• John Goetze Physical Therapy, Inc
• John Goetze Physical Therapy, Inc
• John Morello MD
• John S Boggs MD PA

• Addiction (Substance Use Disorder) Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Addiction (Substance Use Disorder) Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; 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.