NPIMap

Organization Active NPI

Jackson Family Care

  • Mental Illness Community Based Residential Treatment Facility
  • Zebulon, NC
National Provider Identifier
1689720476
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
FCL 092-120 Issued in NC
Legal business name
JACKSON FAMILY CARE
Practice address
221 E Barbee St
Zebulon, NC 27597-2811
Phone
(919) 404-0628
Fax
(919) 266-7901
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary McCullersjackson
Title
Owner Administrator
Phone
(919) 266-5291

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X FCL 092-120 NC Primary

Addresses

Primary practice location

221 E Barbee St
Zebulon, NC 27597-2811

Mailing address

5641 Quail Covey LN
Wendell, NC 27591-7901
Phone (919) 266-5291

National Provider Directory

National Provider Directory
Tax ID family
Jackson Family Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689720476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5641 QUAIL COVEY LN",
            "city": "WENDELL",
            "state": "NC",
            "postal_code": "275917901",
            "telephone_number": "919-266-5291",
            "fax_number": "919-266-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E BARBEE ST",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275972811",
            "telephone_number": "919-404-0628",
            "fax_number": "919-266-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCULLERSJACKSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "919-266-5291"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "FCL 092-120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zebulon, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.