My Peace Keeper II Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

MY PEACE KEEPER II INC.

Practice address

3119 Spring Glen Rd Ste 104
Jacksonville, FL 32207-5921

Phone

(980) 505-0902

Fax

(704) 919-5055

NPI assigned

Aug 18, 2017

Organization subpart

No

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

Authorized official

Name

Virginia Pough

Title

Director of Operation

Phone

(980) 505-0902

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1487170759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3119 SPRING GLEN RD STE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075921",
            "telephone_number": "980-505-0902",
            "fax_number": "704-919-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3119 SPRING GLEN RD STE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075921",
            "telephone_number": "980-505-0902",
            "fax_number": "704-919-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PEACE KEEPER II INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "POUGH",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATION",
        "authorized_official_telephone_number": "980-505-0902"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• My Journey, LLC
• My Medex Lab, LLC
• My Nurse Doctor Primary Care LLC
• My Own Angels LLC
• My Path Mental Health Center LLC
• My Therapist Shannon LLC
• Alissa Meadow Myatt, LCSW
• James Myatt, DPT
• Kaitlin Marie Myatt, APRN
• Melaine Myer, RN

• Case Management Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Case Management Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.