NPIMap

Organization Active NPI

Jackson Medical Transport

  • Non-emergency Medical Transport (VAN)
  • Baltimore, MD
National Provider Identifier
1538860044
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
JACKSON MEDICAL TRANSPORT
Practice address
300 W Redwood St Apt 324
Baltimore, MD 21201-2346
Phone
(202) 446-8874
NPI assigned
Mar 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Mr. Domonique Jackson
Title
Owner
Phone
(202) 446-8872

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

300 W Redwood St Apt 324
Baltimore, MD 21201-2346

Mailing address

300 W Redwood St Apt 324
Baltimore, MD 21201-2346
Phone (202) 446-8874

Other names 1

  • Jackson Medical Transport Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1538860044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W REDWOOD ST APT 324",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212012346",
            "telephone_number": "202-446-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W REDWOOD ST APT 324",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212012346",
            "telephone_number": "202-446-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MEDICAL TRANSPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-12",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DOMONIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-446-8872",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Medical Transport",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.