J&E Jackson Enterprises, PLLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

PO3484 Issued in FL

Legal business name

J&E JACKSON ENTERPRISES, PLLC

Practice address

1677 Eagle Harbor Pkwy # C
Fleming Island, FL 32003-4802

Phone

(904) 278-5112

NPI assigned

Jul 29, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Emily Jackson, DPM

Title

Physician

Phone

(321) 704-1807

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Locations

Practitioners 2

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

• Emily J Ernst, DPM

  • Foot & Ankle Surgery Podiatrist
  • Fleming Island, FL
  • NPI 1407019839
  Medicare reassignment Care Compare group NPD
• Jeffrey Luke Jackson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Fleming Island, FL
  • NPI 1548412992
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518393600000",
    "number": "1346625522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1677 EAGLE HARBOR PKWY # C",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034802",
            "telephone_number": "904-278-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1677 EAGLE HARBOR PKWY # C",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034802",
            "telephone_number": "904-278-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J&E JACKSON ENTERPRISES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2018-02-12",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "321-704-1807",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "FL",
            "license": "PO3484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "FD5660",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rheema Islam
• Island Cove Behavioral Pediatrics LLC
• Island Eyecare PA
• Island Nursing Services, LLC
• Isle Healthcare & Rehabilitation Center LLC
• Jeffrey Luke Jackson, DPM
• Jacksonville Orthopaedic Institute Inc
• Jacksonville Orthopaedic Institute Inc
• Jacksonville Spine Center PA
• James a. Downey, MD, PA

• Podiatric Clinic/Center in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Podiatric Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; 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.