Jackson Medical Supply, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

JACKSON MEDICAL SUPPLY, INC

Practice address

801 W Bay Dr Ste 515
Largo, FL 33770-3220

Phone

(727) 754-3306

NPI assigned

Jan 25, 2018

Organization subpart

No

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

Authorized official

Name

Neeley Matthews

Title

President

Phone

(727) 754-3306

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524873600000",
    "number": "1659879625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W BAY DR STE 515",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703220",
            "telephone_number": "727-754-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W BAY DR STE 515",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703220",
            "telephone_number": "727-754-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-25",
        "last_updated": "2018-04-28",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "NEELEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-754-3306"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. Paonessa M.D. P.a.
• J. Paonessa M.D. P.a.
• J1513, LLC
• J1513, LLC
• David Jabs
• Alizay Jackson
• Kelly Donald Jackson, DDS
• Robin Jackson
• Joshlyn Jacob, AUD
• Frank Mac Jacobs, LMFT, LMHC, CAP

• Durable Medical Equipment & Medical Supplies in Largo, FL
• Providers in Largo, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2018; 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.