Active NPI
Kena Jackson
- Homemaker
- Jacksonville, FL
National Provider Identifier
1336732247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 1211 W 7TH St Apt 1
Jacksonville, FL 32209-7924 - Phone
- (904) 635-0223
- NPI assigned
- Feb 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | |||
| Homemaker | 376J00000X | Primary |
Addresses
Primary practice location
1211 W 7TH St Apt 1
Jacksonville, FL 32209-7924
Mailing address
1211 W 7TH St Apt 1
Jacksonville, FL 32209-7924
Phone (904) 635-0223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HOMEMAKER | Other | HOME CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunshine Provider Services | Single Specialty | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613001600000",
"number": "1336732247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 W 7TH ST APT 1",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322097924",
"telephone_number": "904-635-0223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211 W 7TH ST APT 1",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322097924",
"telephone_number": "904-635-0223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-11",
"last_updated": "2021-02-11",
"certification_date": "2021-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOME CARE",
"identifier": "HOMEMAKER",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.